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Girlfriend finally received Mandatory Reconsideration result

PIPnewbie

And it looks like they just copy and pasted the original result. A meagre 8 points for Daily Living, and upholding of her original award of Standard Rate until June 2020.

Severe Crohn’s since birth that caused her 4 operations at 9, early arthritis, endometriosis, fibromyalgia, and other issues, all ruling her life, needing her to live by the toilet all day every day, getting non refreshing sleep, and life constantly in pain... and 8 points...

So what is the next step of this utter disgrace? How do we go about a tribunal?

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poppy123456

Hi,

With only 18% of MR decisions changing this doesn't surprise me.

Next step, is for her to request the Tribunal and she has 1 month from the date of the decision to do this. She needs to fill out the SSCS1 form and send the MR decision letter with it. Do be aware that waiting times for hearings are huge across most of the country and she could be waiting as long as 1 year for a hearing date. With review due in June this year, this will most likely take her past the decision of the review.

https://www.gov.uk/government/publications/appeal-a-social-security-benefits-decision-form-sscs1

PIPnewbie

poppy123456 said:

Hi,

With only 18% of MR decisions changing this doesn't surprise me.

Next step, is for her to request the Tribunal and she has 1 month from the date of the decision to do this. She needs to fill out the SSCS1 form and send the MR decision letter with it. Do be aware that waiting times for hearings are huge across most of the country and she could be waiting as long as 1 year for a hearing date. With review due in June this year, this will most likely take her past the decision of the review.

https://www.gov.uk/government/publications/appeal-a-social-security-benefits-decision-form-sscs1

Thank you Poppy.

The review is June next year isn’t it? 2020?

Even so, what happens to PIP beneficiaries who are awaiting the tribunal for the original decision in the first place, but who have to go to a review before that?

Pipquestions2

PIPnewbie said:

poppy123456 said:

Hi,

With only 18% of MR decisions changing this doesn't surprise me.

Next step, is for her to request the Tribunal and she has 1 month from the date of the decision to do this. She needs to fill out the SSCS1 form and send the MR decision letter with it. Do be aware that waiting times for hearings are huge across most of the country and she could be waiting as long as 1 year for a hearing date. With review due in June this year, this will most likely take her past the decision of the review.

https://www.gov.uk/government/publications/appeal-a-social-security-benefits-decision-form-sscs1

Thank you Poppy.

The review is June next year isn’t it? 2020?

Even so, what happens to PIP beneficiaries who are awaiting the tribunal for the original decision in the first place, but who have to go to a review before that?

They do the reviews a year early apparently so it's 2019

poppy123456

They don't do reviews yearly, it depends on the length of the award. Reviews take place 1 year before the award is due to end. If the award ends next year, then review is this year.

If review decisions come before the Tribunal hearing and the Tribunal goes in your favour then backdated money will only be up until the date of the review decision.

PIPnewbie

poppy123456 said:

They don't do reviews yearly, it depends on the length of the award. Reviews take place 1 year before the award is due to end. If the award ends next year, then review is this year.

If review decisions come before the Tribunal hearing and the Tribunal goes in your favour then backdated money will only be up until the date of the review decision.

What does a review entail? Another face to face?

And the tribunal can’t give their own award length? Like they can’t give her a 5 year award that overrides the DWP’s decision?

poppy123456

Always class a review as a new claim, there's no difference in the process and face to face assessments are almost always needed. It's rare to have a paper based assessment, even for a review.

Yes, a Tribunal decision length of time can overrule a DWP decision, just like an award can. However, if the review decision comes before the Tribunal decision then the new decision will overrule to Tribunal decision.

PIPnewbie

poppy123456 said:

Always class a review as a new claim, there's no difference in the process and face to face assessments are almost always needed. It's rare to have a paper based assessment, even for a review.

Yes, a Tribunal decision length of time can overrule a DWP decision, just like an award can. However, if the review decision comes before the Tribunal decision then the new decision will overrule to Tribunal decision.

Good god this is a joke

So next time don’t bother with the MR and just go for tribunal? Wish somebody had told me.

poppy123456

That's not possible because you can't request the Tribunal without first asking for the MR. As previously advised you need the MR decision letter when sending the SSCS1 form. The Tribunal request will be refused without this.

PIPnewbie

poppy123456 said:

That's not possible because you can't request the Tribunal without first asking for the MR. As previously advised you need the MR decision letter when sending the SSCS1 form. The Tribunal request will be refused without this.

But then is the point in a tribunal even if they say oh she should have enhanced on both for 10 years, but it comes after another PIP decision to stiff her on points and only award it another measly year before the next review?

PIPnewbie

ilovecats said:

PIPnewbie said:

And it looks like they just copy and pasted the original result. A meagre 8 points for Daily Living, and upholding of her original award of Standard Rate until June 2020.

Severe Crohn’s since birth that caused her 4 operations at 9, early arthritis, endometriosis, fibromyalgia, and other issues, all ruling her life, needing her to live by the toilet all day every day, getting non refreshing sleep, and life constantly in pain... and 8 points...

So what is the next step of this utter disgrace? How do we go about a tribunal?

I'm going to play devils advocate here . . .

I note that all of her problems are physical, and I assume she doesn't have a cognitive or sensory impairment, therefore she probably will not be able to score for Eating, Managing medication, Communicating, Reading, Engaging, Budgeting, or Planning a journey. Unless she has a physical condition which restricts her walking then she won't score for mobility either.

I imagine she has scored 2 points for the following, Cooking, Washing, Dressing and if she is able to manage her Crohn's disease then she cannot score higher than a B for Toileting which is also two points.

Have you ever stopped to consider that maybe she just doesn't fit the criteria for a higher award? I'm not saying she doesn't don't have a horrendous time with her conditions, but I'm sure you know that PIP isn't about diagnosis. Unless you have medical evidence from someone who agrees that she literally physically cannot do all those things maybe going to a tribunal will be more heartache than it is worth?

I know it may not seem fair, and I have a bowel condition so I can sympathise. Perhaps just be content that she has a standard award and in the meantime see how see goes and if she worsens then present medical evidence at the review so prove this?

Well her fibromyalgia is a recent diagnosis (5 days after her face to face), but she suffers with Crohn’s related arthritis, and is often so stiff in her limbs that she can barely walk and her hands and limbs have no strength to open her medication, pull up her jeans or joggers, etc.

I don’t see how she can only score 2 points for toilet needs, since she is incontinent the majority of the time, and distresses her every time.

I am going to take this to tribunal. It would be pointless not to after all this fighting. Everyone else seems to report huge success there, even after scoring 0 points. The person on the Crohn’s helpline agrees it is a ridiculous decision.

And I’m annoyed that it seems anyone can just turn up to the doctor’s office, say they’re depressed, and all seem to get enhanced for both.

poppy123456

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

Distress caused by incontinence won't score her anymore points for managing toilet needs. Does she use an aid? If so and she scored 2 points that's correct. Even if assistance is needed, if they think she can reasonably use an aid then they'll score her 2 points.

djbantiques

ilovecats said:
Unless she had a cognitive or sensory impairment that would prevent her from managing her own incontinence then it’s unlikely she will score higher than B-2points.

Is she under a specialist for her arthritis or take any arthritis medication? Does she have the visual symptoms of severe arthritis? Clawed hands/swollen joints?
These are things that an assessor or tribunal will look for as evidence that her claim she cannot dress herself is true.

If you feel you have a case then go for it but be prepared for a long drawn out fight.

Also, it’s actually quite hard to score for depression, even standard awards. Someone has to have a severe mental health condition to score and even then it’s hard to so without specialist medical input as proof.

This is where the whole process falls down. Assessors not being informed on specialist conditions.
Arthritis medication is not needed in ALL types of arthritis and the visual signs are often not present.

PIPnewbie

I’m sick to death of seeing that diagnoses have little bearing on PIP decisions, but then I explain exactly how she lives, how she’s affected, but then am told I need proof and diagnoses.

She doesn’t have a cognitive or sensory impairment, but she physically cannot lower herself onto a toilet a lot of the time, nor is she able to dress herself, cook without assistance, etc. as her joints, limbs, wrists, knuckles, and legs are so stiff and aching, she cannot use them.

She can’t open her child-proof medication because she just doesn’t have the strength. So she should have had a point for that.

And she definitely needs prompting to take nutrition. Any eating causes her little remaining digestive system pain every single time, so she won’t eat of her own accord. But let me guess, only counts for depressed people who can’t be bothered to cook, not somebody who has legitimately painful symptoms trying to eat.

Also, we provided evidence of the arthritis with the sacroiliitis history in her notes.

It’s not even the lack of points that’s most insulting, but the 1 year until review... as if she’s going to be doing so much better a year from the last face to face, with her lifelong, incurable diseases.

djbantiques

ilovecats said:

djbantiques said:

ilovecats said:
Unless she had a cognitive or sensory impairment that would prevent her from managing her own incontinence then it’s unlikely she will score higher than B-2points.

Is she under a specialist for her arthritis or take any arthritis medication? Does she have the visual symptoms of severe arthritis? Clawed hands/swollen joints?
These are things that an assessor or tribunal will look for as evidence that her claim she cannot dress herself is true.

If you feel you have a case then go for it but be prepared for a long drawn out fight.

Also, it’s actually quite hard to score for depression, even standard awards. Someone has to have a severe mental health condition to score and even then it’s hard to so without specialist medical input as proof.

This is where the whole process falls down. Assessors not being informed on specialist conditions.
Arthritis medication is not needed in ALL types of arthritis and the visual signs are often not present.

I am aware that not all types require medication. What I mean is that if it is severe there will some evidence of it, other than just their word that it hurts. Increased painkillers, specialist referral and input, OT or physio input, failed attempts at advanced medication, GP medical history showing repeat visits requesting help. All of these would indicate the severity is worse.

Most assessors have a pretty good general knowledge of the common conditions and I personally used do some research if someone was coming in with something I hadn’t heard of.

That wasn't a dig at you . Re-reading it does come across that way but wasn't meant to.
Sorry if you thought that way.

poppy123456

You don't need a diagnosis or proof of it to claim PIP. Activity 2, taking nutrition... The defined term ‘taking nutrition’ refers solely to the act of eating and drinking and so the quality of what is being consumed is irrelevant for the purposes of daily living activity 2. Therefore, if for any reason a claimant elects to have a bad or restricted diet, makes dietary choices or chooses to avoid certain foods as part of dietary requirements, they are nevertheless ‘taking nutrition’ to an acceptable standard and therefore will not score under activity 2.

Where did she score those points? You really should look at all the descriptors and what they mean before going any further because it will be a lot work, time and effort if you go to Tribunal and she can't score anymore points for a higher award. How many points did she score for daily living?

Have a look at this link. I'm sure i posted this for you in the past, did you ever take a proper look? It does explain the descriptors quite well. 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

I thought i'd also mention that my daughter has a learning disability and ASD. I applied for PIP for her for the first time in 2017. She was awarded Enhanced for both for 1 year. Of course there's a cure for both of these and she's miraculously going to be able to do everything for herself without any help and support..... not.

PIPnewbie

Poppy, what about needs prompting to be able to take nutrition?

And I love cats, are you a former PIP assessor?

poppy, I’m actually going to bed in a minute. I’m going to read through that link fully. Even if I already have.

poppy123456

Prompting is part of that descriptor but not for your girlfriends condition because she chooses not to eat because of her condition. See my reasons in my previous comment.

However, if a claimant needs prompting to eat because they have a physical or mental condition that affects their ability to make active choices about the food they consume (for example claimants with a learning disability or an eating disorder who because of that disorder need prompting to undertake the physical act of eating), they will qualify under descriptor D.

PIPnewbie

poppy123456 said:

Prompting is part of that descriptor but not for your girlfriends condition because she chooses not to eat because of her condition. See my reasons in my previous comment.

However, if a claimant needs prompting to eat because they have a physical or mental condition that affects their ability to make active choices about the food they consume (for example claimants with a learning disability or an eating disorder who because of that disorder need prompting to undertake the physical act of eating), they will qualify under descriptor D.

I just don't see the difference between that. After all, one's reluctance to not eat because of the pain it causes and dreading each meal is nothing but mental condition. Sad that they'll only consider people with generic issues like eating disorders, etc. and not special cases which legitimately fit those descriptors.

PIPnewbie

ilovecats said:

PIPnewbie said:

Poppy, what about needs prompting to be able to take nutrition?

And I love cats, are you a former PIP assessor?

poppy, I’m actually going to bed in a minute. I’m going to read through that link fully. Even if I already have.

I am indeed.

Were you ever told to lie or to make a mountain out of a molehill, like when my girlfriend could pick up a bottle with 400ml of drink I already opened for her, and then put that she unscrewed it herself and lifting the bottle now means she can bathe herself and cook for herself just fine and dandy?

Yadnad

ilovecats said:

PIPnewbie said:

ilovecats said:

PIPnewbie said:

Poppy, what about needs prompting to be able to take nutrition?

And I love cats, are you a former PIP assessor?

poppy, I’m actually going to bed in a minute. I’m going to read through that link fully. Even if I already have.

I am indeed.

Were you ever told to lie or to make a mountain out of a molehill, like when my girlfriend could pick up a bottle with 400ml of drink I already opened for her, and then put that she unscrewed it herself and lifting the bottle now means she can bathe herself and cook for herself just fine and dandy?

No, not at all. But we are trained to notice things like that. I once had a lady who ‘couldnt’ spinal flex forward to touch her knees during the physical exam. I also watched her drop her phone on the floor and bend down and pick it up which is evidence that she can indeed bend down. I know it seems devious but often people say they can’t do things due to perceived pain (some even outright lie) but then we witness a complete contradictory movement.

Young girl tells me she can’t grip knives to cook - then tells me she enjoys doing make up and did her own make up today (wearing finely applied eyeliner which requires good grip and dexterity)

Woman says she cannot wash her own hair as she can’t lift her shoulders up - then proceedes to put her hair in a ponytail in front of me because she was too hot.

People do things absentmindedly that disproves their claimed restriction and Im not saying there isn’t a chance your particular assessor may have embellished but often people don’t remember doing simple second nature movements.

Crohns sucks. Absolutely I agree with that and she certainly should score at least for Activity 5, but in the absence of a diagnosed mental health condition, high level meds and specialist input it will be very difficult to prove the requirement for prompting.

There was a quote made about PIP by the government. 'PIP is for the really disabled amongst us'