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PIP claim disallowed.

Eadiesmummy1

To say the report was a complete fiction. Assessor states i took off my coat, which i left on through the whole interview..
Anyhow i scored 1 point for medication needs.

I am fuming right now. What do i do next?

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Comments

poppy123456

Hi,

MR is the next step if you've had the decision letter. You need to request it in writing, stating what you disagree with and where you think you should have scored those points. Adding 2-3 examples of what happened the last time you did that activity.

Eadiesmummy1

Thanks poppy. Im gutted but hoping the mr might work xx

lizzieloz30

Hi @Eadiesmummy1 so sorry to hear that. Do what @poppy123456 said take it to MR.

Yadnad

Eadiesmummy1 said:

Thanks poppy. Im gutted but hoping the mr might work xx

Less than 17% 'win' a MR.
Be prepared to go to appeal - if you feel that your health could stand the stress.

Eadiesmummy1

I will take it all the way. Since my application i've been diagnosed with a new condition plus hospitalised 4 times been upped on my medication 6 times and changed medication twice..I have no blink reflex in left eye or left leg. My neuralgia has worsened to the point i feel suicidal. I will even take to the tribunal stage if necessary. When i rang he said they made a decision on Thursday but didnt recieve NhS report until friday. xxxx

Tilly1

Eadiesmummy1 said:

To say the report was a complete fiction. Assessor states i took off my coat, which i left on through the whole interview..
Anyhow i scored 1 point for medication needs.

I am fuming right now. What do i do next?

I can understand why you are angry my assesser wrote on my report i walked with a stick which i don't!

CockneyRebel

Eadiesmummy1 said:

I will take it all the way. Since my application i've been diagnosed with a new condition plus hospitalised 4 times been upped on my medication 6 times and changed medication twice..I have no blink reflex in left eye or left leg. My neuralgia has worsened to the point i feel suicidal. I will even take to the tribunal stage if necessary. When i rang he said they made a decision on Thursday but didnt recieve NhS report until friday. xxxx

They cannot take any new condition into account for this claim. Any change in your condition must have been in place for 3 months and likely to continue for a further 9

Eadiesmummy1

it is lifelong illness, although it was only diagnosed in october xx

poppy123456

A diagnosis makes no difference to a PIP claim. It's how those conditions affect your ability to carry out daily activities against the PIP descriptors.

katies

I can see why you are angry I've just been turned down after review and the report was nothing like the interview a whole pack of lies I'm going to tribunal any ideas on what I need to put in the box marked reason for appeal

poppy123456

@katies Have you requested the MR? You can't request the Tribunal without first asking for this because you need to MR decision letter.

Pippa_Alumni

Welcome to the community, @katies! Scope's page on appealing DWP decisions may help you to get started.

https://youtu.be/4sOsiEFo-Ck

katies

Thanks for your replies I have done the MR and have the letter I am now appealing to the Tribunal and I am having difficulty in knowing how
much information I should put in the reason for appeal any ideas what I need to include any help would be appreciated thanks

CockneyRebel

Appeals do not have to be scary

Many people, having gone through the assessment process, then the Mandatory Reconsideration are still let down by the system.
In order to get justice and the award they deserve, the final stage is to appeal to a tribunal.

Usually, a tribunal is a panel made up of a judge, a doctor and a disability specialist. This is an independant panel, given the task of looking at all the evidence from both parties, and come to an unbiased decision. In many cases, the panel will want to clarify with the claimant some of the evidence, or give the claimant the chance to explain.

If you are able to attend the hearing this is more easily achieved, however to some, the accumulated stress makes this impossible and a hearing can be held based just on the paper evidence with out the need to attend. It is also possible now to request a telephone or skype hearing

In all cases, the judge will notify you before the hearing if he believes that the current award is unsafe, which means that you may lose points and your current award. If this happens you do have the option to withdraw your appeal and keep the award you have.

This all sounds so scary that many people don't progress to this stage and settle for a lesser award than they deserve. Having already sent in all your possible evidence, what else can you do to persuade the "court" that you deserve a higher award ?

The simple answer is nothing. You have done everything you can.

Or have you ?

Often, the problem is not your evidence, which proves beyond doubt that your condition is real and affects the way you complete the daily tasks in line with the decriptors.

The problem is with how your evidence is presented.

Think about it. If you were a DM or a tribunal panel, would you want to read through the equivalent of War and Peace in medical evidence ? Would you even be able to stay awake to do so ?

Presentation to an appeal panel is made easy for you. You have already done all the work of collecting and submitting your evidence and GP letters where possible. The DWP has sent you back a copy of everything, "the bundle", all you need to do is present your case in an idiot proof form.

Make it easy for the panel to understand why you deserve the award.

We have all had the HCP report that at best can be described as a work of fiction. Attacking the HCP will not score you any points
The panel don't care ! The job of the panel is to make a judgement on your functionality and your job is to present your reasons in a straight forward manner.
Complaints about assessors are a separate matter and have no place in appeal submissions.

My "how to template", a formula put together over a year and eight successful PIP claims, may be of use if you want to give it a try. It is not magic, it is not a guarantee of success. You may think it is a load of ****, feel free to disgard it or make comments.
If it makes sense to you and helps you to appeal in a less stressful way, feel free to use it.

Template for appeal submission

MY best advice is, make it simple and idiot proof.
You do not need to try and find even more paperwork, you have already sent in all your relevant evidence

Write a brief history of your claim, condition and how it affects your daily life.

Example:

I am 61 years old and have had rheumatoid arthritis, multiple joint osteoarthritis and lupus for most of my life. The condition is permanent and deteriorating despite medication to slow the process. The painkillers I take have an effect after a few hours but before they kick in, I have difficulty washing and dressing and the pain make it very hard to get around.

You may agree with some of the points awarded, in which case say so and reference these to the bundle so the panel can easily find the information if they want.

Example;

Undisputed descriptors

Managing toilet needs 2 points (page 64 of the bundle)
Communicating verbally 0 points ( page 66 of the bundle )
etc.

Next move on to the descriptors that you are disputing. Again reference each point to the bundle.
State what you were awarded. What you believe you should have been awarded and why.

Example:

Disputed activity
Preparing and cooking food
I was awarded 0 points for preparing and cooking food ( page 60 of the bundle )
I believe that I should have been awarded 4 points for this activity
I need help to cook food, I can prepare vegetables whilst sitting but I cannot reliably, safely and for the majority of time, lift hot pans due to limited dexterity, poor grip and pain in my wrists and hands ( ref GP1, GP3 of the bundle. GP's letter ) There is a clear danger that I will drop things and scald myself and therefore need my wife to do this when necessary.
The assessment took place at 09:00 when I was fully rested and with the benefit of full pain medication. The HCP stated that I had a normal power and pinch grip at the time ( pages 59 & 60 of the bundle ). However ,I do not believe that the assessor took into consideration the effect of fatigue and the diminishing effect of my pain relief during a typical day, especially at meal times later in the day.

Do this for each descriptor that you dispute.

Finally write a brief summary of the above.

In conclusion, due to the snapshot nature of the assessment, I believe that the assessor did not take into consideration how my conditions affect me during a typical day or how the effects of fatigue and diminishing pain relief impact on my capability to carry out the activities as the day wears on.
I believe that I should have been awarded XX points for the care component and as agreed 12 points for moving around.
My conditions are permanent and deteriorating yearly ( GP 1 ) with no chance of remmission. As my condition varies from day to day, I request that the hearing takes place on the paper evidence as I am unable to ensure my attendance.

Your faithfully.

These are true examples from a submission used which resulted in a higher award being given.

I hope this helps some of you tro realise that tribunals don't have to be scary or hard to do.

CR

Pippa_Alumni

Hi @katies, there's also some good information about completing the tribunal form and what to include in this on the Citizens Advice website:

The most important part of the form is Section 5: Grounds for appeal. In this box you need to give the specific reasons why you disagree with the decision.

Use your decision letter, statement of reasons and medical assessment report to note each of the statements you disagree with and why. Give facts, examples and medical evidence (if you have any) to support what you’re saying.

You might have done this already for your mandatory reconsideration letter - if so, you can use the same examples and pieces of evidence again.

You should also look at the points system the DWP uses (called descriptors) to assess PIP claims to see where you might get more points. It's important to use the right evidence. You can look at our guide to how the DWP makes a decision to help you.

You can include all this information on a separate sheet if you’d prefer, just write ‘See enclosed information’ in the box and attach any papers securely to the form.

Tribunals can look at your whole award again. So you should consider whether you risk losing your current award - for example, if you've got evidence to support a daily living component but might lose your mobility award because you can now move better. If you're not sure, you should get advice from your nearest Citizens Advice.

katies

CockneyRebel and Pippa thank you so much for all your help I really appreciate what you've done for me

Eadiesmummy1

Its MS so affects me a lot compared to how i was at the assessment. I'm writing MR tomorrow, getting as much medical information as i can mon. xx

Spibes

I'm sorry this happened, I appreciate the way you helped me prep for my pip assessment still awaiting the result of mine. I hope the MR goes in your favour.

Eadiesmummy1

@Spibes how are you stranger? me too. im fighting it all the way! hope your decision is a good one xxx

Spibes

I'm doing okay few panic attacks this past week and haven't been able to go online for a while, my assessment was yesterday.

I went to the assessment centre in Wigan, my mum came with me and her boyfriend gave us a lift I mads sure the nurse knew that I was taken there by car not my public transport and my mum takes me everywhere.

I explained when I asked I needed prompting to take medication, to eat and to wash on bad days and can only cook through a microwave meal.

I also explained my mum and gran manage most of my bills and budgeting and my housing officer manages my housing benefit and council tax side.

I did make a slight blunder she was reading my form and asked me about not understanding signs and said I wrote it there I didn't understand at first but clarified it was about road signs.

It lasted about a hour, she asked a lot of questions, she wasn't nice but wasn't nasty more so just cold and robotic.

Fingers crossed for you x