PIP Review Refusal for 16 year old - What happens now?

simplemick

Morning all,

I was wondering if anybody has had experience of going through a PIP renewal assessment and it being refused? Were you able to challenge the decision successfully?

Our son has had a kidney condition and posterior urethral valves since he was born. In all this time he has been awarded disability living allowance most recently through the Personal Independence Payments system. He has just had his first review as an adult which we were present for, but we have just had his decision back saying that all allowances are to stop, even though there is no change in his condition. He has a Mitrofanoff which means he has to catheterise every 2.5 hours and is fully catheterised overnight.

We can't quite understand what is changed from the last 16 years to now as the areas that we raised were not about him being able to feed and clothe himself, rather than lack of feeling and regular small accidents that occur that can be hugely embarrassing.

We will appeal, but is there any realistic chance of the decision being overturned if they didn't take into account his needs in the first instance?

We would be interested to know other people's experience of refusal after such a long time of acceptance.

Thanks in advance.
Mike

Rachel_Scope

Hi @simplemick. I'm sorry your son's claim was rejected. I've been through the appeals process all the way to tribunal and I was successful. Unfortunately, it's quite common to be turned down at the first step. Your next step is a mandatory reconsideration (MR). Here are the descriptors used for PIP. Go through each one and write down how your son is able/unable to do these day-to-day. I would suggest doing the MR in writing as you then have a copy of exactly what you've said without relying on a person on the phone taking notes. It may go to tribunal but if it does don't lose heart. I was successful at tribunal as they actually listened to me and I spoke to a medical professional. The same goes for many other people. Hopefully you'll be successful at the MR though.

poppy123456

You said he's 16 so are you sure this was a PIP review and not a new claim for PIP due to transferring from DLA?

It's important to know the difference between the 2 benefits because both are completely different, with very different criteria. PIP is more about the activities and descriptors but DLA was more about day and night time care needs.

simplemick

https://forum.scope.org.uk/discussion/comment/916949#Comment_916949

Hi, thanks for the response. My error, yes it's DLA to PIP as he is 16 now and having to make the claim himself albeit with us for guidance.

It was a bit of a shock going from higher rate DLA to nothing. I get some sections about eating and feeding yourself would not apply, but the catheter and infections and the fact he has zero feeling for needing to go to the toilet and accidents at college etc didn't even register with them.

We'll look at the appeals and hope for the best.

poppy123456

Thanks for confirming that my thoughts were correct. PIP and DLA are completely different and claiming DLA for all those years doesn't automatically entitle him to PIP. I'm not saying he's not entitled because I don't know anything about how his conditions affect him.

PIP isn't about a diagnosis, it's about how those conditions affect you. Are you his appointee? if not is he able to manage his own claim? If he isn't then speak to your son to ask if he wants you to manage his claim. You will then be responsible for filling out forms, answering questions during assessments, receiving any money into your bank and using it in his best interests and reporting any changes in the future if he's eventually awarded PIP.

You will need to ring PIP to ask to become his appointee. They will then arrange this and send a DWP representative to your home.

https://www.gov.uk/become-appointee-for-someone-claiming-benefits

For the Mandatory Reconsideration (MR) request. You should put this in writing stating where and why you think he should have scored those points. When the form was filled out if you didn't include a couple of real world examples of exactly what happened the last time he attempted each descriptor that applies to him you should do that now. Also include detailed information such as where he was, what exactly happened, did anyone see it and what the consequences were.

Remember, PIP is all about the descriptors. For more understanding of those I'd advise you to have a read of this.

https://www.gov.uk/government/publications/personal-independence-payment-assessment-guide-for-assessment-providers/pip-assessment-guide-part-2-the-assessment-criteria#daily-living-activities

For eating that would come under activity 2, taking nutrition.

simplemick

https://forum.scope.org.uk/discussion/comment/917141#Comment_917141

Hi,

Thanks again for the response. Yes I am the appointee until he is 18, we decided this would be best if all medical communication with doctors, hospitals, PIP etc was done by us but with him present and contributing to give him responsibility but make sure he hasn't missed things (he's 16 of course he's going to miss things!)

Maybe I'm merging PIP and DLA more than I should, the response from PIP did just seem to say that you have issues - deal with it, rather than looking into the specific issues he has and accounting for them.

Thank you again for responding and I'll update as and when to help others.

poppy123456

The appointee isn’t automatically removed when he reaches 18. It will continue until you ask for it to be removed. You should only be an appointee if they are mentally and physically incapable of managing their own claim.

PIP is not about the conditions itself but more about how they affect you. Did you have a read of that link I posted above? If not then please do have a read.

simplemick

I have had a read of the guidance you posted, thank you.

The reason why I don't understand the original rejection would be that he scored very low on the assessment, yet according to the link you posted he should score in multiple areas.

Maybe I'm just completely misunderstanding the system. Maybe at 16 we/he are expected to just get on with it, or make adjustments to our lives to fit the scoring system despite doing it differently for 16 years.

Just seems very strange that there is such a big difference in managing a condition that somebody has had since birth until the 16th birthday that has to change so dramatically the day after.