PIP, DLA and AA
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Should I appeal my PIP decision?

maekinmaekin Member Posts: 6 Listener
edited August 2018 in PIP, DLA and AA

Hi, I was given a lifetime award of the higher rate DLA for both components following a long stint in icu, I was described on my medical notes as the illest person ever to survive. I klebsiella pneumonia and sepsis throughout the system, I was completely paralysed and need to learn how to walk again, this left me with numerous conditions including neuropathy, cervical myelopathy, degenerative bone disease and chronic fatigue syndrome amongst others. These conditions are severely debilitating and affect my life in many ways. I have medical evidence and was diagnosed following many tests including an mri scan 10 years ago. I was told there is nothing can be done for me except to ease my symptoms with medication and strong pain relief. I am on a lot of medication including slow release morphine and oral morphine, I was also told that I will eventually need an operation on my neck to relieve pressure on the spinal cord, but because of the risks involved this will only be performed when there is no alternative. When I applied for PIPS the award was the standard rate. I scored 10 points for mobility losing the vital points on planning and following a journey. I only scored 2 points on things like preparing food because I need an aid. I only missed out by a few points and I was disgusted as my quality of life is poor. So I appealed, from start to finish the process has taken almost 2 years but I felt certain that the award would be changed. I have just received my results and the appeal has been lost. Although it is accepted that my medical evidence proves I suffer from the conditions stated it is felt I am only entitled to the standard rate, mainly due to my ability to speak and converse with others which is true however this does not reflect the depression and anxieties that have affected me for many years, I am on diazepam and sertraline. At the tribunal there was no attention paid to me, how I mentally coped with my situation and the constant pain I am in. I feel useless, embarrassed and at the end of my tether, sometimes my whole body feels like lead and I have no energy. I rarely go out as it is extremely difficult even with my carer, it is not just what I can or can’t do it is how I feel. You can’t see pain or understand how someone is feeling unless you are going through it yourself. I have recently moved to be closer to family, my last property had adaptions but the house I now live in doesn’t and due to this decision, I don’t think it will be possible to get the help I need or adaptions i need to be safe. I feel let down and abandoned by the system. What conditions are eligible for the higher award. Because I am not an alcoholic or drug addict and can think for myself I am being penalised. Can I appeal and is it worth it, could I succeed this is something that I feel strongly about?

Replies

  • Chloe_ScopeChloe_Scope Scope Posts: 10,653 Disability Gamechanger
    Hi @maekin and a very warm welcome to the community! Thank you very much for sharing your story with us all. I am sorry to hear about your health and your difficulties with PIP. Have you taken the PIP online self- help test? Despite this test not being concrete it may give you an indication of points you would be entitled to. I would mention that PIP is not based on any conditions that you have been diagnosed with it is about how your daily life is affected because of any diagnosed or undiagnosed conditions. Good luck with whatever you choose to do!
    Scope

  • maekinmaekin Member Posts: 6 Listener
    Hi, thanks for your advice. I did the test twice, the second time I answered in a way that gave me minimal points and I was awarded the enhance rate on both occasions, the only way I could have been awarded the standard rate is if they did not mark me correctly on 2 questions, getting in and out of the shower I need assistance, and made that clear but have not received the correct points and also taking nutrition I explained i needed prompting yet got no points had I got just 1 point for this I would have got the enhance rate. This does not seem fair is there anything I can do.
  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    Hi,
    I'm sorry to hear this.

    It's not about what conditions you need to gain the points, it's how your conditions affect you. If you can eat and i mean eat anything whether it's just junk food because you can't get the food yourself,  you won't score any points in taking nutrition.

    The only way you can now appeal the decision is by asking the Tribunal for the statement of reasons. You have 28 days to do this and once you have it you need to find someone to look at it and find an error in law. If an error in law was made in making the decision then you can appeal, if it wasn't then it's the end of the road, i'm afraid.

    May i ask when is your review? Maybe you can concentrate on getting more evidence, doing some more research into what the descriptors mean exactly before the review. What you said about taking nutrition tells me you don't completely understand some of them.

    Good luck.
    Proud winner of the 2019 empowering others award. This award was given for supporting disabled people and their families for the benefit advice I have given to members here on the community.
  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    What points did you score for washing and bathing? you say you need assistance getting in and out of the shower?
    Proud winner of the 2019 empowering others award. This award was given for supporting disabled people and their families for the benefit advice I have given to members here on the community.
  • markyboymarkyboy Member Posts: 368 Pioneering
    You can only appeal a tribunal decision on a point of law which i doubt has happened in your case ,your best option is to wait for your review if you are already 2 years in to the award it should be soon.
    Before you present your case again ask your GP for a referral to an occupational therapist for a home visit and explain your difficulties in carrying out these PIP descriptors they can provide aids and produce a report this will go a long way in getting you the points you deserve next time 
  • maekinmaekin Member Posts: 6 Listener
    My award is until 2020, the examples given where just random examples based upon the self assessment test, I only know what I was marked down on in my original claim, you are right i don't know much about how it works, nutrition was a bad example. The CAB helped me with my claim and written the evidence statements on my behalf, my problem is that they seemed to have ignored the areas that i also need supervision along with the use of an aid even though I felt that had been made clear to them, it just seems unfair that i passed for the higher rate of ESA without a problem, that DLA was awarded permanently 10 years ago yet i have missed out on getting the help i desperately need due to a couple of points.
  • maekinmaekin Member Posts: 6 Listener
    i scored 2 points because i need an aid but that is for balance whilst in the shower, i also need help washing and supervision.
  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    Your ESA and DLA award are different to PIP. You need to ask for the statement of reasons and take it from there. PIP awards are reviewed 1 year before the award is due to end. If yours is until 2020 then review will be 2019.
    Proud winner of the 2019 empowering others award. This award was given for supporting disabled people and their families for the benefit advice I have given to members here on the community.
  • YadnadYadnad Posts: 2,856 Member
    edited August 2018


    Two other things leap out. One is the idea they’ve not taken into account your pain. You’re probably correct. Unless you explicitly stated you couldn’t perform specific points scoring activities because of one if the above 4 reasons and therefore needed an aid, prompting or help from another person then no, they won’t have taken into account your pain.

    Allied to this is how you cope, your depression and anxieties. Again, you need to link these to specific points scoring activities. I also noted the use of morphine. It’s not hard to see how a tribunal would read that as you having much reduced pain in consequence.

    My guess is that you were unrepresented and, of that’s accurate, you really need a rep to help you identify an error of law and assess the merits of your case.
     
    You are so right in that if you fail to identify clearly which of the descriptors you are requesting that they accept and the reasons why you have the difficulties in doing it then it is a fair comment to make that they damn well will not have even thought about the pain issue. If you don't make it clear then you can't expect them to go looking what might be the descriptor you are looking at.

    On the face of it I too would expect that taking MST & Oramorph for pain relief should be a red light indicating that pain is a big issue. However the more I think about it the taking of that medication could be said to have reduced the pain level therefore making life that much easier. This allies with the use of aids and adaptions - the more you have of them the less the amount of points would be granted. From memory it is only 2 points for aids but a lot more if physical help is needed.

    Wouldn't it be a fantastic world if there were a glut of WRO's who would see a case through from start to Tribunal for every claimant?

    I do agree with you in that the claimant did the damage to themselves at the hearing. However very few claimants manage to get that level of support as you know. So many appear at a Tribunal unprepared with inadequate evidence and the inability to put forward their case in the best light which is not their fault, but unfortunately they themselves are the ones that will suffer.
  • mikehughescqmikehughescq Member Posts: 6,532 Disability Gamechanger
    Yadnad said:


    Two other things leap out. One is the idea they’ve not taken into account your pain. You’re probably correct. Unless you explicitly stated you couldn’t perform specific points scoring activities because of one if the above 4 reasons and therefore needed an aid, prompting or help from another person then no, they won’t have taken into account your pain.

    Allied to this is how you cope, your depression and anxieties. Again, you need to link these to specific points scoring activities. I also noted the use of morphine. It’s not hard to see how a tribunal would read that as you having much reduced pain in consequence.

    My guess is that you were unrepresented and, of that’s accurate, you really need a rep to help you identify an error of law and assess the merits of your case.
     
    You are so right in that if you fail to identify clearly which of the descriptors you are requesting that they accept and the reasons why you have the difficulties in doing it then it is a fair comment to make that they damn well will not have even thought about the pain issue. If you don't make it clear then you can't expect them to go looking what might be the descriptor you are looking at.

    On the face of it I too would expect that taking MST & Oramorph for pain relief should be a red light indicating that pain is a big issue. However the more I think about it the taking of that medication could be said to have reduced the pain level therefore making life that much easier. This allies with the use of aids and adaptions - the more you have of them the less the amount of points would be granted. From memory it is only 2 points for aids but a lot more if physical help is needed.

    Wouldn't it be a fantastic world if there were a glut of WRO's who would see a case through from start to Tribunal for every claimant?

    I do agree with you in that the claimant did the damage to themselves at the hearing. However very few claimants manage to get that level of support as you know. So many appear at a Tribunal unprepared with inadequate evidence and the inability to put forward their case in the best light which is not their fault, but unfortunately they themselves are the ones that will suffer.
    That’s a misreading of what I said. I’ve no idea whether the claimant was represented or not and definitely no idea as to whether they did themselves a disservice. All I observed was based solely on the original post.

    Tribunals are inquisitorial so to some extent you can expect them to go looking but they have limited time and so you need to direct them.

    Finally, I actually don’t think it would be a great world if everyone had representation from start to end. What a damning indictment of the decision making process that would be. The fact is that even if every area had a plentiful supply of face to face advice it would still only reach the tip of the iceberg. Most claimants get successful claims into payment without any assistance but equally that is often more luck than judgement and the quality of information out there to help them do that is, to say the least, patchy. 

    On here alone you regularly get people telling others to give up and start again; to describe what they’re like on their worst day; to only request a statement of reasons (totally forgetting about a record of proceedings); that errors of law are hard to find and so on. It’s profoundly poor advice and depressing to read.
  • markyboymarkyboy Member Posts: 368 Pioneering
    I am talking from experience regarding a point of law and it is a grey area and to say it's poor advice and depressing to read is only your opinion and other members should ignore this.
    My first tribunal was set aside on a point of law that the tribunal did not explain the legal reason for changing my award but the judge who made this decision warned that the new tribunal will make it's own mind up about the facts and how the law applies to the facts and what one judge decides it's a point of law another judge might not agree and can overturn it .
    You do not need a representative to find a error of law because what they think is an error of law a judge might disagree.
    So telling people to get representatives who can spot an error of law is bad advice and gives people false hopes.
  • mikehughescqmikehughescq Member Posts: 6,532 Disability Gamechanger
    @markyboy. I am a professional WRO and have been for 32 years. I am happy that the information I have given is accurate. Your experience is your experience but it is not the experience of the majority of claimants and you should not claim that it is. I have literally seen 1 case in that time where I could not see an error of law. It’s near impossible for a tribunal to not err when writing state,Rhys after the fact. People are always welcome to ignore advice but telling them it’s wrong, bad advice and depressing is rude and wholly inaccurate. 

    There is also no false hope involved as my point b) is explicitly clear in saying that finding an error of law is only half the battle. An adviser will look at the merits of the claim and may often advise that whilst a tribunal appeared to have erred in law there’s no point in pursuing it further as a rehearing may only award the same or less based on the existing evidence. 

    There are lots of things claimants can and should do for themselves but this is absolutely not one of them.
  • markyboymarkyboy Member Posts: 368 Pioneering
    A forum is all about opinions and what you post is your opinion and just because you say you are a professional WRO does not mean that what you post supersedes other members opinions.
    People who look for advice will make their own mind up which advise they act on otherwise we might as well call it the Mike Hughes forum.
  • mikehughescqmikehughescq Member Posts: 6,532 Disability Gamechanger
    I’m sorry but that’s a total cop out. If something is factually correct then an opinion saying it isn’t is just that unless evidence. Your evidence is what exactly? Your case? 

    Where I post a personal opinion I say so. Where I post a professional one I also say so. The latter is based on 32 years experience and 1,000s of clients in multiple settings. It’s also explicitly based on knowledge of the law, case law, guidance and taking many cases to UT including several which set precedents.. As I said, your experience is your experience but I am more than happy to state unequivocally that you are wrong in calling such things a grey area and you will in most instances need a rep to identify an error of law. Most claimant led appeals to UT wrongly appeal on a point of fact but might be aided by judges then spotting a potential error of law. In no way does that make a case for going without a rep. 

    Let’s be clear, you didn’t ask other people to make up their own mind. You explicitly said my professional opinion should be ignored. Putting aside the arrogant rudeness and ignorance of that, the knowledge base you have for saying any of it is literally your own case and nothing else. So, yes, let’s let people make up their own minds. 
  • YadnadYadnad Posts: 2,856 Member
    A point well made Mike. Maybe if markyboy was to search on Rightsnet and view the contents of your submissions on that site he may well concede the point he is trying to make.
  • mikehughescqmikehughescq Member Posts: 6,532 Disability Gamechanger
    edited August 2018
    Yadnad said:
    A point well made Mike. Maybe if markyboy was to search on Rightsnet and view the contents of your submissions on that site he may well concede the point he is trying to make.
    More likely he’d tell them they were all only expressing opinions :)

    Great article in the media this week about how some people’s “right” to hold an opinion in defiance of absolutely demonstrable is now held to be more important than a fact being right. 
  • YadnadYadnad Posts: 2,856 Member
    edited August 2018

    More likely he’d tell them they were all only expressing opinions :)

    Great article in the media this week about how some people’s “right” to hold an opinion in defiance of absolutely demonstrable is now held to be more important than a fact being right. 
    The country's gone barking mad I say it's gone mad!
  • mikehughescqmikehughescq Member Posts: 6,532 Disability Gamechanger
    edited August 2018
    Here’s one if the articles I was thinking of. Not this week. I will gladly hold my hands up to being factually incorrect :)

    https://www.theguardian.com/media/2018/jul/29/digital-media-opinion-facts-comment?CMP=Share_iOSApp_Other
  • mikehughescqmikehughescq Member Posts: 6,532 Disability Gamechanger
  • YadnadYadnad Posts: 2,856 Member
    Mike I am so glad that being of the age that I am, I can exclude this digital rubbish from my life and still continue to know the absolute difference between fact and opinion!
    However I do feel extremely worried for my grandchildren who can't tell the difference and end up believing that my opinion must be the way of the truth and that fact is an inconvenient obstacle to stride over.
  • maekinmaekin Member Posts: 6 Listener
    Thank you for all of the posts, I have written a letter to request both a statement of reasons &  a record of proceedings. At the tribunal I was asked many questions mostly concerning aids I had at my last property ( an adapted bungalow), these questions were very black and white yes or no answers that I tried to elaborate on and point out that I have no adaptions now that I have moved, I was told to concentrate and answer only about the bungalow which I feel is wrong as I have not lived there for over a year the predominant time that I have been waiting for this tribunal. Anyhow in the aspects where I have been given points for needing aids I need assistance from a carer as well, this would have given me more points yet it has been ignored. I have cerebellar damage resulting in poor balance, so along with the use of aids I often need assistance from my carer to get around, especially when I am disoriented at night or when I am tired. another example is I need an aid (grab rails) to get of the toilet however I also need supervision due to suffering from urinary retention, the consequences of this is I will quite often fall asleep on the toilet usually when I need to go at night, which is not safe. My legs go numb like dead weights, i lose all feeling in one or sometimes both, so I need help to stand, regain some feeling and help walking. I also need help getting in and out of the bath/shower and to wash my hair and lower body this is alongside the aids that are used to help me balance. The morphine does not get rid of the pain especially after 10 years it simply helps me to be more comfortable when stationary, it does not allow me to walk far as my legs and arms are like lead weights and my legs give way when they tire. I also only have 40% lung capacity making it hard to do exercise such as swimming that could help my muscle development. The chronic fatigue syndrome can be debilitating and has a large impact on my life as the deteriorating bone, myelopathy and spinal condition. I wasn't asked how my life is affected just what aids I used in the bungalow, not even what aids I now need. I also have to sit with fans or ice packs on my feet to try and alleviate the intense pins and needles caused by nerve damage. It is exhausting to do menial tasks.
  • mikehughescqmikehughescq Member Posts: 6,532 Disability Gamechanger
    The tribunal are not looking at you as you are now. They’re looking at you at the point at which you made a claim so it would be absolutely correct to look at your previous property.
  • KafolegKafoleg Member Posts: 21 Connected


    maekinmaekin Posts: 6Member Listener
    August 9 edited August 9 in PIP, DLA and AA

    Hi maekin.

    Thank you for shared your story with us. I am sorry to hear your lost your life time award and then lost your appeal in tribunal after 2 years.

    That's so awful! If someone as ill as you lost in appeal then it is no hope for many other claimants. I myself just received PIP decision to stop my lifetime mobility award after reduced from High rate to standard rate and now a last chop to be stopped.

    When I went to meet my PIP assessor I was so believing that I will be treated fairly by being seen and examine by a doctor....So I wasn't preparing my self for anything or I didn't looking out for any information about PIP award... I just so trusting that's PIP already have all kept my medical history in they system. So I was just being myself and believing I do get pass and get reward again. I was so shock to learn of my mobility stopped.

     Reading everyone post here I realized I am not alone.

    Thank you everyone ...I have so much to learn here.   

    @kafoleg

    • YadnadYadnad Posts: 2,856 Member

      When I went to meet my PIP assessor I was so believing that I will be treated fairly by being seen and examine by a doctor....So I wasn't preparing my self for anything or I didn't looking out for any information about PIP award... I just so trusting that's PIP already have all kept my medical history in they system. So I was just being myself and believing I do get pass and get reward again. I was so shock to learn of my mobility stopped. Reading everyone post here I realized I am not alone....I have so much to learn here.  

      Yes I would say that you do.
      I went into my first assessment on moving from DLA to PIP and thought the same.
      What a shock I had.
      As for my second and third re-assessments I just went through the motions telling the assessor what they wanted to hear and not what they should have heard, I too lost all faith in the system so basically I didn't really care what happened as the result would be negative in any event. 
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