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A PIP Mandatory reconsideration that wasn't requested!

Don

Hi,
I am wondering if this has happened to anyone else, I've googled and not found any info.
I was awarded standard rate PIP after a home assessment by ATOS.
After a few weeks I received a Mandatory reconsideration decision letter stating that I now no longer qualified and they had decided on every single point that I now score 0 points and have nothing wrong with me at all. (I wish they were right)
I phoned them, the man was quite rude, I asked him how I was supposed to pay them back when I had already bought aids and supports that I needed, he told me a debt collection agency would be in touch.
Apparently the secretary of state had looked at it and decided I'm fine.

I asked if they could look at again, the man on the phone took all of my details and difficulties all over again.
He also told me writing in with my reasons I felt they were wrong would help.
I wrote in and heard nothing so I called again.
The woman on the phone said they had my letter and were looking at it again, she said it was marked as urgent and someone would call me back in 24 hours.
Later that day, I was called back, the woman told me they had not changed their decision, it was not marked as urgent and the woman who told me they were looking at it again was wrong, they were not considering anything.Once the secretary of state has made a decision it cannot be over turned.

She told me I could appeal and that could take months, basically she made me feel like I am a fraudster.
I asked her how she could look at my medical notes and tell me there is nothing wrong with me and she told me they have not looked at my notes!
She also assured me I have many months to file for an appeal, however as far as I am aware it is 4 weeks from the MR letter date. (The MR I never asked for)

I have filed for an appeal, sent recorded, arrived in time, and I feel totally and utterly emotionally battered.

Why do we not have a warning that they could decide to look at the claim again out of the blue, call us liars and demand the money back?

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Comments

BenefitsTrainingCo

Hi Don,

It sounds like you've had some very mixed up advice there and I would consider complaining about the DWP (they have a complaints procedure). Meanwhile you've done the right thing by appealing.

A PIP decision can be changed by the Secretary of State (in practice, a DWP decision maker). This can be for lots of reasons: any reason at all within one month of the decision, or after a month if they think an official error has been made, or if they think there was a mistake about facts or facts they didn't know at the time of the original decision, and that means you should get less benefit. So unfortunately PIP decisions can be changed without you asking for a mandatory reconsideration.

You've done exactly the right thing, and you should get this sorted out. One thing that might happen is that when they look at your appeal, the DWP decision maker could revise it again. That would mean your appeal lapses - you'd be informed of this.

It's also the case that you have have one month to appeal from the date of the revised decision (whether that happened due to a mandatory reconsideration or not). You don't have 'many months', although late appeals are possible if you have good reasons for a delay.

I'd definitely complain about the bad advice. I would insist that the DWP sort this out asap and tell you what is happening, and what the current award of benefit actually is (I assume that you have not been paid during this time). Insist that they respond to your appeal form, telling you what has happened, and if your appeal has lapsed, why that is (for example, because the original decision awarding you standard rate was never changed, or has been revised back to what it was).

You don't say whether you are getting standard rate of both daily living and mobility or one of them. Just make sure you're specific in the appeal (I'm sure you have been) because the tribunal can look at both components if you do end up having an actual hearing.

Finally just to say that it is odd to get a mandatory reconsideration notice if you haven't asked for your decision to be looked at again. When the DWP revise a decision for the reasons above they are not applying for a revision - they are just using the powers they have to revise, either within one month or at any time if they have grounds. So it does sound like some sort of error has been made.

You might want to approach your MP about this as well. Your MP's surgery could help you with some of the steps above, and it's important that MPs know how badly the system is working. Alternatively, you could approach your local CAB - they all feed evidence back on aspects of the benefit system.

Good luck and do post again if you have any developments!

Will

Don

Thanks Will,
I will keep you updated as I do feel like a few errors have been made too.
I received standard rate daily living and nothing for mobility, however the payments stopped as soon as I received the MR decision letter, it also informed me I had been over paid and would receive details of how to pay them back soon.
(Never did get any info there)
All the advice has been over the phone, each time I have phoned since the MR the operators seem puzzled and put me on hold while they try to work out what is happening.
The MR was decided the same day it was filed for, and even the DWP staff don't understand why or how that has happened, thankfully I have two copies so one has been sent off now.
Thanks for the link for complaints, I will look at that in a moment.
Some of my problems are very embarrassing for me to discuss, and going over and over it on the phone has been difficult, I don't think I've got the energy to go over it again with an MP or CAB, I feel really silly having burst into tears on the phone to DWP a few times already.
Text is easier on my sanity now I think!
I am keeping a paper trail though and my SSCS1 form was delivered to the tribunal last week with as much evidence as I could gather in the few days they'd given me.

Just a case of biting my nails and hope common sense prevails!

BenefitsTrainingCo

Yes I really hope so Don. I've come across a lot of odd things happening with PIP but this is the worst! It's as if someone requested an MR...but it wasn't you, and the DWP don't need to request them, so it makes no sense.

I totally understand re not wanting go over it with any more people in person/on the phone. So I'm really hoping that the your appeal will mean the DWP realise they've made a massive error and put it all right again without you having to do anything further. If it does go to an actual hearing I can imagine the judge being very critical of the DWP!

Do complain if you have the energy. This sort of thing is completely unacceptable. And definitely don't pay anything back (hopefully, you won't have to, and that will get clarified).

Will

Don

I have the DWP response to my appeal, and they have looked at my notes again and decided I still score 0 on all descriptors, they have requested the tribunal dismiss this appeal.

I have gone through the whole pile of documents returned, medical evidence, my medication etc it's all there,
I assumed it must have been a terrible report by ATOS that we see so much of in the news, but no.
She has noted the lack of grip in my hands, obvious pain and my limited movement.

The only odd thing I can see is they wrote to ATOS again for an opinion and the response seems to agree with the DWP.
A supplementary advice note dated 7/10 where I seem to have been cured almost completely!

Am I right to believe the tribunal will read all this and see sense or should I write to ATOS and ask how I was cured?

Oh and not only am I cured, my more minor conditions are unlikely to last more than 12 months, lucky me eh?

I have just emailed the tribunal with a note to point out a couple of glaringly obvious missed points.

BenefitsTrainingCo

Hi Don,

I would suggest complaining to ATOS so that you can tell the tribunal you have taken up with them their incorrect statement that you have improved. Ask ATOS what evidence they have for this.

If they are claiming you've got better since they've seen you, it isn't that relevant anyway as the tribunal are there to discuss what the facts were at the date of the original decision.

In any case, if you can show evidence that there's no change in your conditions, and nor could there be expected to be (for example, in relation to the minor conditions, show that they are simply wrong), that will help.

If possible, prepare a submission of your own with the history of your case, stating the law, the points you think you should get and the evidence for this, plus (as you have already clearly done) explain why the DWP conclusions, and the later ATOS evidence, is just wrong.

It's great to get help with this if you can, for example from a CAB, but if not there are lots of resources out there, such as PIPinfo where you can look at the activities and how they may relate to various conditions.

Do keep us informed. It's best if you can to state your case again (even though I know you've done so many times) as you can't be sure the tribunal will otherwise realise the lack of logic in the DWP interpretation.

Will

Don

Hi Will
Thank you.
They are not saying I have improved, they are saying I was never entitled to anything.
I went through all of the appeal papers this morning and sent a complaint to ATOS.
I can see what has happened, they have taken a minor problem that only flares up once or twice a year and decided to base my whole claim on that.
Even on my original report the nurse has noted that one arm has chronic symptoms but the other only once or twice a year. (That is due to a very old shoulder injury).

I have sent the tribunal a labelled body map , hospital notes, a very long description of my problems and a point by point response to the DWP decision.
I will also let them know I have complained to ATOS.
I have also let ATOS know I am posting on here.

Looking through all of the paperwork I think the fact I take part in a sport has flagged something in their system and they have decided because I can do that I must be fine, they appear to have asked ATOS to look at their points and a nurse (not the one that visited me) has agreed if I can do this, I must be fine.

It is something I love to do, but cannot do it often and each time I do it causes me pain, but I would rather be having fun doing that than sitting indoors in pain.
I have explained how I manage and cope, with help!

I only managed it about 4 times last year, but I'm not going to stop doing it.

Are we not allowed to have fun?
I honestly think looking at all the papers I have here the tribunal will easily see what has happened.
My medical history is long and complex, but it seems no-one has looked at my medical records.

I don't know if I should laugh or cry!

Don

Just to add, the DWP also have the same copies of my notes, but I am sure they never bothered to look

Don

I have just recieved a letter telling me my appeal was refused.
It seems an ATOS member of staff that has never met me overides the decision by the ATOS nurse that did my assemement.

What can I do now?

BenefitsTrainingCo

Hi Don

I'm sorry this continues to cause so much difficulty. I agree with Will - you are likely to need help with this from a local advice service. We can offer expert advice but we're not in a position to offer a casework service on this forum and it seems that is what you need.

If you are not sure of your local services please do contact the Scope helpline on 0808 800 3333.

David

Don

Thanks David,
Is it OK to keep this going with any updates?
I couldn't find any info online where this had happened to somone else, so I hope that it might help anyone who does find themself in this situation.
(although I hope they don't)

I live in the middle of no-where so online support is easier for me.
I have reapplied and will be giving the details in a robot fashion.
I can see what happened and have complained to both DWP and Atos.

Somone flagged my case and put in the MR (the secretary of state apparently) they asked an ATOS nurse to go through it again, this nurse has focussed on one issue and not the whole picture, and the appeal has agreed with them, however, I was originally given 8 points after a physical assesment, then ATOS reviewed it a month later and took me down to 0 points without seeing me.
The appeal have agreed with that decision, yet have given me 4 points, also without seeing me.

BenefitsTrainingCo

Hi Don,
I'm really sorry but if you have gone through both MR and appeal stage, the next step is to say that the tribunal made an error of law and seek permission to appeal to the Upper Tribunal.

It's really NOT something we can guide you through online, even though I understand that online support is easier for you.

What you can do as a first step is get in touch with the tribunal and ask them for a written statement of reasons. You'd need that to seek permission to appeal anyway. I know they made the decision without seeing you, but did you opt for a paper hearing? If so, then that in itself isn't something you can complain or appeal about. But they shouldn't have given you a paper hearing (where you don't get the chance to appear before them) without asking you.

An error of law can include taking things into account which shouldn't have been taken into account, and failing to take into account things which should have been considered - but you can't really know if that happened without the statement of reasons.

The thing is that we won't be able to look at the reasons for you, because as David points out, we don't offer a casework service. But I suggest you ask for the reasons anyway, within one month of your getting the decision notice.

There may have been an error of law here because the tribunal appears to have accepted evidence from an 'assessment' where you were not even seen! They should therefore explain their reasons for doing so and their reasons for apparently discounting your own evidence.

You've done exactly the right thing by applying again. But I absolutely urge you to raise this with your MP (they may not need you to go to their surgery in person?). Your MP will have an email address.

I know how emotionally draining this has been and it must seem never ending. But I am concerned that even if you apply again and it all goes smoothly, you will miss out on the money from your previous claim. So do ask for the statement of reasons, as another next step. After that, see what you think and consider seeking permission to appeal (this request for permission goes to the first tier tribunal, and you would have to explain what the error of law was).

You can see why this isn't something we would suggest you do without expert local advice so again, I would consider seeking this although I completely understand if this isn't possible for you.

Will

Don

Hi Will,
Yes I do understand you can't do casework from here, but I just wanted to check it's OK to post updates here.
I've not had a call back about my DWP complaint yet, I am hoping that is because someone is going through the paperwork, although I don't have faith now.
I will ask for a written statement of reasons and will also contact my MP.

Thanks again

BenefitsTrainingCo

Hi Don

Just to add to what my colleague Will said about applying for a written statement of reasons. Once you have received them it may be possible for you to obtain representation remotely for assistance with an application for permission to appeal to the Upper Tribunal if you qualify for legal aid.

You would ordinarily qualify for legal aid in these matters if you are in receipt of an income-based benefit such as income-related ESA, income support or income-based JSA. If you are not in receipt of any of the benefits I have mentioned you might still qualify if you have a low income and a low level of capital; any provider will carry out a check on this for you.

You should be able to obtain a list of organisations with a legal aid contract for welfare benefits appeal to the Upper Tribunal by contacting the Upper Tribunal office on 020 7071 5662 or emailing adminappeals@hmcts.gsi.gov.uk and then it's down to you to contact them. The details I have provided are if you live in England and Wales, if you are elsewhere in the UK then the relevant contact details can be found here

Hope that helps and absolutely feel free to post updates on here

Best wishes

Paul

Don

Thanks Paul & Will.
I have not yet received the statement of reasons or heard any more following my complaint to ATOS and DWP, although they have told me it could take some time.
I reapplied for PIP at the start of Feb, if anything my condition is getting worse.
I had a very long home assessment from ATOS, she went into great detail to get a good picture of how I cope day to day, I did physical tests too.
I have now been awarded PIP at a higher rate than before.

I will let you know how the complaint goes, I have a local Councillor who is willing to help me if need be.

Don

Hi Thisisit.
DWP decided I didn't have to pay it back, paper tribunal decided DWP were correct,
They thought I was awarded wrongly because they only took into account an old shoulder injury that flares up once or twice a year, they told me it was for long term conditions etc and totally ignored two very obvious chronic conditions I have that affect me day to day!! If I had not mentioned the occasional shoulder problem it probably would have gone through OK!
I reapplied with all the same evidence and medical conditions, ATOS came to my home, spent hours talking, gave me a physical exam, checked out my drugs etc and I have been awarded PIP.
I now know it can be stopped at any time without warning though

Don

No Thisisit, thatwasthat I already felt humiliated and degraded, really don't want to drag it out further than it did already, it was horrible!