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PIP Appeal & PIP ATOS Assessment running in parallel?

GhostriderGhostrider Member Posts: 2 Listener
Hello everyone,

Just joined having discovered this site through Google while attempting to research a curious situation concerning my PIP claim.

I had my most recent PIP application processed and awarded in 2015, everything was fine until June 2018 when the DWP sent me a form to fill in for a 'Mid Term Review' of my claim. I returned the form confirming no change in my disability since 2015, and expected the review to either rubber stamp the 2015 decision as still accurate and vaild, or arrange for me to undergo an assessment.

Unfortunately when the DWP informed me of the outcome of the review at the beginning of December 2018, things started to go badly wrong. The exact details aren't relevant to my query, other than to say, that despite having accepted my disability was a valid one, and having awarded me various benefits on the strength of that disability for over the 26+ years that it had existed at that time, the review decided, for reason(s) unknown, that I did not have the disability I claimed to have for all those years at all, but actually had another disability that I don't have, and never have had.

This created a situation where they were paying me PIP for a disability I didn't have, and had never ever claimed for, so I saw no option but request a mandatory reconsideration. I was informed of the outcome of this mandatory reconsideration in late February 2019, and despite it having been very forcefully pointed to the DWP that the review outcome was awarding me PIP for a disability I did not have, never have had, and have never claimed PIP for, they stuck to their guns and refused to change their decision.

This left me little option but to lodge an appeal, which was done on 18th March 2019 with the Courts & Tribunal service, who informed me that they would advise the DWP I had lodged the appeal, and once they were in receipt of the DWP's response I would be sent a copy and invited to comment, after which I would be advised of a date for my appeal to be heard once it had been sent.

All good as far as I was concerned. I've heard nothing from either the DWP of the Courts & Tribunal service since, and I presumed things were just wending their way through the system.

However I have now received a letter from ATOS advising me that they have been instructed by the DWP to undertake an assessment on my PIP claim......

I have no problem with completing an assessment in principle, but where does this leave my appeal, is it normal or even permitted that the DWP several weeks after being made aware an appeal has been lodged against them, for them to run an assessment on the same claim as is being appealed in parallel with the appeal?

If this is standard practice, or at least acceptable practice, does it not open to door to endless un-necessary entanglements and confusion. With both the appeal and assessment running on flexible timelines there is no way of knowing which will be completed first, and the only scenario in which no problem would arise is if both appeal and assessment upheld the decision of the review. If both appeal and assessment go ahead but reach different conclusions, who over-rides who, and if the assessment is completed before the appeal is, and over turns the review decision, the appeal becomes pointless and is a total waste of everyone's time and resources, to mention only two of the several possible outcomes of an appeal and an ATOS assessment running in parallel on the same PIP claim.

Replies

  • CockneyRebelCockneyRebel Member Posts: 5,258 Disability Gamechanger
    Hi @Ghostrider and welcome

    Apart from being awarded PIP for a condition that you don't have, did you receive the level of award that you expected ?

    Is the reason for your appeal because of the wrong condition or the level of award ?

    Appeal waiting times are up to a year so the new assessment will likely be completed before your appeal.

    The new assessment will mean a new decision which will replace the one that you are appealing.
    If the new decision gives you the award that you currently have but based on the condition that you do have then you can cancel the appeal.

    If your appeal run to completion then it will be limited to the time of the new decision

    If the new decision is not acceptable then you will need to start a new MR/ Appeal
    Be all you can be, make  every day count. Namaste
  • GhostriderGhostrider Member Posts: 2 Listener

    That brings a bit more clarity to the situation. Thankyou.

    The review deciding I have a condition I don't did result in a reduction in my award. So, yes, it was lower than expected.

    While I intend to use both the wrong condition and reduced award as part of my evidence to support my appeal, I made it on the broader generic grounds 'that the decision maker did not follow the correct review, revision etc procedures when considering my entitlement'. As having enquired deeper in to how this situation has arisen, I believe that is where the root of the problem lies.

    Long story, but I will try to keep it as brief as possible.

    IN 1992 I developed quite painful/uncomfortable and very debilitating symptoms which my then GP diagnosed as 'Central Nervous System damage of unknown origin', the cause of which were presumed to be either a legacy of an unidentified infection/virus I'd been quite ill with for several weeks immediately prior to developing them, and/or an adverse/allergic reaction to one of the medications I'd been prescribed in an attempt (unsuccessful) to treat that illness.

    Once both myself and my GP were confident my neurological symptoms had stabilised and were no longer active, further discussions concluded that beyond the physically disabling effects I was experiencing the condition did not pose any threat to my general health going forward, so it required minimal monitoring which I was more than capable of doing myself. Likewise the possibility of being seen by a neurologist was discussed, and while my GP was quite amenable to organising this, he pointed out that in his opinion he did not believe I would benefit from doing so in any way. As he did not believe a neurologist would be able to provide any more accurate of a diagnosis than he had already given me, and that regardless of my exact diagnosis, there were no treatments available for nerve damage which would encourage faster healing than the natural healing process did.

    While the above may come across as unusual or surprising given the attitude, culture and procedural policies of the NHS today, it was very much 'situation normal' within the NHS of 1992 when it happened.

    Given that seeing a neurologist would have involved a 400 mile round trip, and caused me a considerable amount of pain and discomfort throughout, and considering that by all accounts I would achieve no practical benefit from doing so, I took y then GP's advice just to allow the natural healing process to do its work and see what happened.

    And there is pretty much where things have sat ever since. For the first 8-10 years any comment on my condition was restricted to him enquiring how I was doing, and me replying either 'Just the same' or occasionally 'xxxx has improved very slightly'. Until we both accepted it was going to be an extremely long term if not permanent condition, and stopped talking about it.In fact we were no longer in contact, as there was nothing to talk about, I had an untreatable permanent condition which did not need monitoring, and I just had to learn to live with it. So unless I had any other reason to consult with a GP, which I didn't we were simply wasting each others time, and between around 2002 and 2014 I had no contact with any medical professional at all.

    Following my GP giving me a diagnosis of 'Central Nervous System damage of unknown origin', in 1992, that is the only diagnosis I have ever used to claim any benefit, and the DWP have accepted it without question as a valid diagnosis throughout, until last year. I presume any contact they had with my GP during that time also provided them with information that satisfied them.

    The root of the problem seems to lie with the fact that my GP from 1992 onwards moved on to another position in 2006. I presumed that he would leave adequate notes behind that allowed his replacement to carry on where he left off, or if not his replacement would contact me to better appraise himself of my situation.

    For the first eight years that his replacement was in post I heard nothing from him, so I presumed he was happy with whatever documentation he held on me. IN 2014 I had occasion to contact that GP on a benefits admin issue, and he expressed a wish to see me, which he did. I expected for hi to at least ask a few basic questions about my disability and how it had been in the then 12 years since I'd been in contact with a GP, but he seemed wholly uninterested, responding with little more than a grunt or a nod any time I mentioned anything to do with it, and changing the subject back to what appeared to be his sole aim. To be a 'salesman' by trying to talk me in to having this or that test done as 'at my age its a very good idea to have these done regularly'. I had no interest, so the meeting quickly terminated. In the five years since he has requested to see me three more times, and each meeting has followed pretty much the same format and outcome as the first.

    So, in a nutshell, my current GP knows virtually nothing about me or my disability, and I would have expected him to at least have contacted me to discuss it before responding to any approach from the DWP.

    How an issue concerning my disability and my benefit entitlement hasn't come up between 2006 and 2018 I do not know, and can only presue that throughout that period the claims I made were approved without the DWP making contact with my GP. However, they did choose to make contact with him last year as part of this PIP review, and (as I've only found out after the fact by pressuring my GP for answers as to what had gone on that has led to the present ludicrous situation) instead of my GP admitting to the DWP that in fact he was largely ignorant of my disability. He, for whatever his reason was, proceeded to present himself as being fully coversant with me and my situation, and although he claims he told them he was aware I had neurological symptoms, he didn't confirm to them that his predecessor had diagnosed me with 'Central Nervous System damage of unknown origin' as 'that wasn't a proper diagnosis'.

    Rather, he claims to have advised the DWP that they had no diagnosis on record for me, and then appears to have gone in to some long waffling speculative diatribe with them on all the different possible conditions my symptoms (or at least those he's aware of) 'might' be.

    The end result being that the decision maker (probably very confused by it all) has simply cherry picked from the above possible conditions my GP had gone on about, and run with that.

    I appreciate that in the DWP and NHS worlds of 2019 'Central Nervous System damage of unknown origin' is a very vague diagnosis, but its the only one I've got, and my GP admits it is a matter of record in my notes. It is only he who refuses to divulge it as by his opinion its 'not a proper diagnosis'.

    Everything else my GP appears to have speculatively rambled on about the the DWP not only do I have no current diagnosis for, I've never had a diagnosis for, nor have I even consulted with any medical professional about.at any time. Hence, I take the view, rightly or wrongly, that by simply cherry picking from a speculative rambling list of 'possibilities' offered by my GP, and allocating me conditions I have no diagnosis whatsoever for, 'that the decision maker did not follow the correct review, revision etc procedures when considering my entitlement' is the best grounds to base my appeal on.




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