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We want to hear from you: please tell us about your experience of the online community.

PIP journey

DaveMycroft

I've been on standard level of PIP since 2011 following a C3/C4 disc prolapse that went undiagnosed for 6 weeks and by the time they determined the cause of my symptoms the disc was through the spinal fluid and pushing halfway into my spinal cord, causing permanent nerve damage.

In July (5th) I informed them that my issues had got worse and requested a reassessment. I now have Asthma, COPD, spastic quadriparesis, osteoarthritis, Barret's Oesophagus, cervical myelopathy, paraspinal muscle spasm and high blood pressure.

Today December 10th) I had an hour long telephone assessment with a nurse. An hour later I was informed that she had submitted her report. I'm mainly posting here to give people a timeline of how the system is working at the moment, in Cheshire, as there have been few posts about how long each step takes 2024. I'll update when I get a decision.

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Comments

Rosie_Scope

Thanks for sharing your experience @DaveMycroft, and welcome to the community. Lots of members find reading these helpful so we appreciate you taking the time to let us know how your experience has been.

I hope your decision comes through soon and you get the result you're hoping for 😊

DaveMycroft

Well only 4 days after the telephone assessment I've got a copy of the assessors report, but no decision as yet. The assessors consultation report is a catalogue of factual errors and omissions from missed diagnoses in the History of Conditions, to reporting neck injuries and an operation as being back injuries and operation and even an "IO (Informal Observation) showing no pain" that was somehow done over the phone. Mostly it's a series of assessments that say the HOC and report from 8 years ago say everything show no pain/impact despite the fact that I am reporting a change that's backed up by new disc bulges and osteoarthritis. The conclusion is that it's accepted that it's degenerative but it's stayed the same so standard rate of both Daily Living and Mobility. I expect the decision to follow this and PIP helpline say I can't dispute the report until the decision is made - then put in for a Mandatory Reconsideration (along with the new medical reports received since putting in for a review).

Rosie_Scope

Sorry to hear you've had that experience @DaveMycroft, that's really frustrating. The PIP line are correct here, but once the decision comes through you can challenge it at mandatory reconsideration. Lots of members have been through this if you have any questions about it, so you won't be alone if you need any advice at the next stage.

Hope your decision comes through quickly so you can get started.

DaveMycroft

Thanks Rosie, but no problems. I can show very clearly where things have been omitted, misrepresented and are even created from this air (alleged answers to questions I was never asked). I spend about half my time as a tenants advocate with both our Housing Association and the Housing Ombudsman's Residents Panels using my journalist training to fight cases based on the Law. It won't be the first time I've taken on the DWP and won. It just means waiting a little longer to go onto higher rate, and a larger backdated lump sum. Of course this is assuming the DWP just follow the assessor's ratings for each question despite the contradictory evidence.

Rosie_Scope

Oh that's good @DaveMycroft, I'm glad you're able to advocate for yourself. It's frustrating to have to fight but it sounds like you've got some good experience to help you push forward with the challenge if you need to. Once the decision comes through hopefully things will be clear and I'm sure you can make a good case for yourself.

DaveMycroft

Probably more importantly is I can give others a bit of up to date timescales on how long it's taking between assessment and decision, then how long before a Mandatory Reconsideration. Obviously that will be for this geographical area, but for many the most frustrating part is having no idea how long things are taking.

Rosie_Scope

That's always helpful @DaveMycroft thanks for sharing your experience, I know lots of members find it useful to read about timelines just to get an idea of what they might be in for.

DaveMycroft

The latest update: On Friday I emailed the Health Assessment Advisory Service's assessors for this region, Maximus. I detailed the 7 specific diagnosed conditions that the assessor had failed to list in the "History of Conditions" along with points where she quoted answers to questions which had never been asked and occasions where she had added "alone" to totally change the context of answers - e.g. "He is happy to take a taxi alone" when I always have my son with me. I also noted that the assessors report consistently stated that nothing would have changed since my assessment in 2016 - only to then state that as my conditions were degenerative and would only get worse, not better, that no review would be required for 3 years. Maximus have now stated that they will investigate this assessment via an independent assessor.

I followed this up with a telephone call first thing this morning to the PIP/DWP helpline 0800 121 4433 and explained that I wanted to make a complaint. I explained all the above issues, and then listened as he read back the notes he had made listing every issue. I was then assured that these details would be added to the file to be sent to the Claim Manager as the decision has not been made yet.

It was important to get this complaint in prior to the decision, as it effectively gives me an extra opportunity to argue the assessment. Should the decision remain the same then I still have the Mandatory Reconsideration, and appeal if needed. This is also why it's a good idea to ask for a copy of the report as soon as practicable, preferably the day of the assessment or on notification that the report has been forwarded to the DWP.

I now await further developments.

DaveMycroft

I am still awaiting a decision from DWP, but have had a response from Maximus to my complaint about the report the Health Assessment Advisory Service's assessor made.

The complaint was investigated by a a senior clinician, who works alongside the Client Relations Team. This review is carried out from a clinical perspective and is intended to identify any potential issues of quality, detail, consistency and medical justification with any such issues being reported directly to the Department for Work and Pensions (DWP).

The complaint is quite detailed and addresses all of my concerns with the quality of the assessment and report. I won't bore you with the specifics but will get straight to the conclusions which say:

"Having reviewed your report the CRMA has advised that this did not meet the required quality standards in line with DWP guidelines. The report produced by the HP does not consider all the evidence on file.

The CRMA has contacted the decision maker for the DWP and offered recommendations in relation to your claim. This concludes the quality review; In order to see how these recommendations might impact on the award you would need to speak with the DWP."

While I don't know, yet, whether this has made a difference and bumped me up to higher rate in either Daily Living or Mobility I do think it was worth getting the complaint in prior to the decision being made, and would definitely recommend others file a complaint with the HAAS if they feel the report doesn't reflect the reality.

karen19862

Thanks for sharing , this exactly the same for me dealing with a very poor and flawed assessment. I had the same response from maximus and my report was re- done on 27th november 2024, I am still waiting for a decision too and I logged my MR on 21st November 2024.

It's not good on the anxiety all this waiting but if it was done correctly in the first place then we would know by now whether awarded or onto the next step, hope you hear soon, the last contact from them was 20th December saying the aim to look at my MR by 06/03/2024, however I do know its now with the decision maker.

If you give them a call and ask to be put through to a decision maker explain what your letter says and that you have been told to contact to discuss it ,they may give you what's been changed on your report but it's always just a recommendation as we already know

Good luck

DaveMycroft

I had a letter a week ago, dated 24th December, which said they now have the information they need to decide……but of course this new information hadn't been provided at that time (I assume) so I'm hoping that they haven't made a decision yet. If so it will probably mean a Mandatory Reconsideration.

karen19862

I would still ring to see what has been changed they told me but it wasn't with the decision maker who could decide not to award but will see. Hopefully you will get a result soon one for the better.

DaveMycroft

Oh the reply from Maximus says exactly what has changed and comparing that to the original report and the descriptors I'm pretty confident that I'll now get 12 points on each of Daily Living and Mobility. I am on the phone right now to DWP to let them know about the new information and request that they don't make their decision until they've seen it. Yes, the unusual request for them to possibly delay making a decision!

karen19862

It doesn't tell me on mine but the rest of the letter is pretty much the same, I'm just hoping the decision maker is kind and goes with the new assessment report

DaveMycroft

Just been told that Maximus contacted the decision maker directly and the new recommendations Only dated yesterday) have now been upload to the DWP system. No decision has been made yet, but it will take the new recommendations into account. Fingers crossed, it's only been 5 1/2 months so far.

karen19862

Wow that's great fingers crossed for you. The waiting times drive you mad but apparently good things come to those who wait I suppose I'm only 8 weeks into MR another 7 + to go.

I hope it's soon for you , you have waited long enough

Good luck

DaveMycroft

The decision has just landed, so the wait time from asking for a review to the decision has been a little over 29 weeks.

After review they've decided to change my score from 8 to 11 for Daily Living; agonisingly 1 point short of Enhanced Rate. They have, however, moved my Mobility score from 10 to 12 and therefore Enhanced Rate.

Importantly they have also made this award for 5 years. The reason that is so important ant is that it will take it to 6 months after I reach pension age - meaning that it is effectively "for life" as you continue to receive PIP after reaching pension age only if you were already receiving it.

I do have the option of going for a Mandatory Review in the hope of getting another single point on the Daily Living assessment, but I'm going to take some time to think about it.

karen19862

Well done, congratulations, you can relax a bit now.

DaveMycroft

https://forum.scope.org.uk/discussion/comment/974644#Comment_974644

True, although as my issues are degenerative the report does state that my condition is only likely to get worse. The important part was getting an award that takes me into retirement so that it can continue.

DaveMycroft

https://forum.scope.org.uk/discussion/comment/974650#Comment_974650

@noman Fingers crossed for you. I'm a few years behind you and before I put in the complaint to Maximus they were suggesting a 3 year award (with 8 and 10 points). It shows that sometimes it's worth getting the report before the decision and complaining if it's not been fair.