PIP Mandatory Reconsideration and possible repercussions

Cartini

Good Morning,

The weekend is on the horizon

A relatively simple question with, hopefully, a relatively simple reply.

I was awarded Enhanced for Daily Living and 4 points for Mobility.  I believe I should have received 8 for Mobility (I can walk, but with pain / discomfort for "interrupted" walks).

I`ve prepared my application for a Mandatory Reconsideration, but before I post it, and replies will dictate whether or not I do, my question is:

How likely is it that the Decision Maker will "mark me down" for Daily Living while assessing my PIP2 responses for mobility?  I keep reading this is possible, but it`s something I`d rather not chance.

I`m happy with the result for Daily Living; I can now make further changes around my house with the award (over the bath shower to walk in shower / wet room, bannister rail on the stairs, grab bars etc).  I don`t want to jeopardise Daily Living for the sake of an extra 4 points.  Any additional money would help with these tasks but I don`t want to push for 8 points and chance losing Enhanced Daily Living (standard Daily Living and Standard Mobility will both be less than I`m currently receiving).

Thank you,

Andy

poppy123456

The most likely outcome will be the decision will stay the same. However, it has been known for points to be taken away at this stage and lose what you already have, as well as an increased award.

Unfortunately, no one here can tell you whether there's any risk to your current award. For this you will need to get some expert advice. https://advicelocal.uk/

Cartini

Thank you Poppy123456

Sue_Alumni

Hi Andy,

You are completely correct that the DWP decision maker can look at the decision in its entirety. You cannot “cherry pick” what you want the DWP to consider but its always open for you to direct the Decision Maker to the parts of the decision you’re not happy – for example by explaining that you accept the Decision Maker’s findings in relation to the Daily Living component but disagree in relation to the decision relating to the mobility component.

I am assuming that your 4 points are in relation to Mobility 2 and that you did not previously have a mobility component in your PIP.   In making your decision whether to request a MR I would suggest you take the following into account:-

1.You need to give the DWP more information about your difficulties in mobilizing in order to give them a reason for revising their decision. The Decision Maker should consider whether you can carry the mobility activities safely, to an acceptable standard, repeatedly and in a reasonable time period for the majority of the time.  Give an example of a typical journey you can do – you could use google earth to do a map showing your journey, how far you walk and here you stop and rest. Explain how long you stop and rest and why you have to stop – pain? exhaustion, nauseous? How long does it take you to do this journey? So if your journey is 500m and you have to stop numerous times after say walking 40 metres you should get either 8 points if you can manage this unaided for the majority of the time or 10 points if you need an aid.

2.Do you have supporting evidence relating to your difficulties in mobilizing.  Draw the Decision Makers attention to specific comments by a consultant.

3.Is it worth considering whether you could score points under mobility 1.  Did you score points for activity 9 Daily Living?  You might score 4 points for needing prompting to undertake a journey...?

4.Your age? If you are approaching pension age you should be aware of restrictions claiming PIP after pension age. In the case of the mobility component if your previous award did not include a mobility component you cannot be awarded one in your new claim.

It's a tough one... unfortunately it is very common for the DWP to make decisions like this to encourage people not to submit a MR

Hope this helps  

Cartini

Hi Sue_Scope,

Thank you very much for your reply.

I hope my thread didn`t come across as though I want to cherry pick, I certainly didn`t mean that; I just want to be sure I`m making the right decision in submitting a Mandatory Reconsideration.

Sorry, I should have been clearer.  Yes, my points are in relation to Mobility 2, this is my first ever application for PIP (for any benefit, come to that) and I`m 60, so a few years away from state retirement age.

Daily Living Activities 2, 9, 10 and Mobility Activity 1 didn`t / don`t apply to me.

For the PIP2, I went into considerable details explaining my predicament; 52 pages worth of answering the activities, providing evidence; consultant letters, MRI scans results, diagrams, letters from the Veteran`s Agency (I`m a War Pensioner) and a week`s worth of diary entries.  To give a "picture" to the assessor I also used an example of walking to my local shop, which is 171m away (by Google Earth).

My main drive gate is 25m from my back door - by the time I get to the gate I have to rest for a few minutes to ease the vice like grip on my spine.  I`ve given distances and times taken throughout all my PIP2, whether outside or inside.  I`ve been very clear and constant about the impact my spondylosis has in both times and movement, so much so I couldn`t muster any more evidence for the MR.

Throughout PIP2 I`ve emphasised "could not repeat", "severe discomfort and pain", "breathlessness", "safety", "stopping for a rest" and, even though I didn`t actually say slower than an able-bodied person, I certainly made it clear that it takes me a long time to complete any activity, not just walking.

Throughout the PA3, the assessor wrote (quote) “Significant pain and suffers with fatigue“,

“Significance of pain and restricted movements“, “The symptoms of pain and fatigue“, “The significance of pain and restricted spinal movement“ and “Significant pain and fatigue“.

But for Mobility 2, she seems to have had a reset and forgotten everything from the previous half hour in that she say`s all this "suggests that he can walk 200m".

Thank you,

Andy

Sue_Alumni

No... cherry pick was the wrong expression but the bottom line is the DWP is entitled to look at the decision in its entirety.  From what you say I think you have grounds to be awarded enhanced rate mobility.  I think the decision maker has failed to take into account that you cannot walk the 25 metres to your gate safely and reliably and to a reasonable standard for the majority of the time and you should not therefore be assessed as being able to walk more than 20 metres.  Are there some days when you don't feel that you can manage even this short distance  and perhaps don't go out at all - does this happen the majority of the time ?  While completion of an activity is not expected to be pain free, completing a an activity when suffering significant pain is not completing an activity in accordance with the PIP criteria. You should explain how long it takes to walk this short distance and that there is nowhere for you to stop and rest before you get to the gate, even though you may need to, and you have no choice but to walk through the pain.  Furthermore you are unable to repeat this period of mobilization. You should also try to give an example of how you manage when you're out and about- would you normally be only able to mange less than 20 metres ?.  Unfortunately while you have good grounds it is not unusual for the DWP to ignore this and base its decision on a flawed medical assessment.  If you are going to request an MR I would suggest going the whole way and asking for enhanced mobility. … you're unlikely to be awarded this at MR but you might get standard rate but I would not like to second guess this... I'm sorry, its a tough call and I'm sitting on the fence but good luck with whatever you decide and I hope I've been of some help. 

Cartini

Hi Sue_Scope,

Thank you very much. 

Yes, you have been very helpful and I do understand that it is a tough call; "day of the races", "which way the wind blows" or even "which side of the bed the Decision Maker gets out of".

There are days I just spend on the sofa to avoid the pain, and that`s having a detrimental effect on my waistline.

I was (almost) fine until I hit 60 when Mother Nature said "Ha ha, Andy, you`ve had your fun, now it`s my turn"

Thank you for your help Sue_Scope, I`ll mull over this over the weekend then decide.

Andy

Sue_Alumni

Good luck !

calcotti

Sue_Scope said:... unfortunately it is very common for the DWP to make decisions like this to encourage people not to submit a MR

I think that's imputing motive which is questionable. The fact we often disagree with the decisions doesn't mean they are doing it in order to discourages MRs.

Sue_Alumni

Thanks,
Addressing your points briefly,
 - yes as I advised a claimant can be awarded PIP mobility component after pension age but only if they already had (or had in the previous 12 months) a mobility component in their PIP award.  It was for that reason I asked the age of the community member as I thought it could be relevant to a decision to request a MR.  
- I note your comments about being selective but still think a claimant should be aware that the DWP Decision Maker is entitled to look at the entirety of the decision under appeal. 
- What I meant by a typical journey in relation to mobilization is one which the community member would make and would illustrate their difficulties with mobilization. The community member referred to his journey from his front door to his gate so he could demonstrate how far he could walk.  This is a typical journey and he was able to give full details of it, length and the time it took him to make that journey and how he felt - in other words was he able to complete the PIP activity in accordance with the PIP regulations

calcotti

Username_removed said:

You absolutely can be awarded PIP mobility after pensionable age. See https://www.rightsnet.org.uk/forums/viewthread/16308

I thought the ‘loophole’ discussed in that thread was closed by these regulations
Social Security (Personal Independence Payment) (Amendment) Regulations 2020
https://www.legislation.gov.uk/uksi/2020/1235/made

Cartini

Hello,

My apologies - I meant to reply to this sooner, but my "colander mind" took over.

In my rush to get the information down, I forgot to include crucial elements.

Thank you for your replies, they allowed me to decide to submit a Mandatory Request.

I`ve submitted a Mandatory Request asking for the Decision Maker to reconsider Mobility question 2.  I`ve also reiterated the distances where the pain starts, gets worse and where I have to stop (which I failed to include in my first post (the 171m is a round trip, not one way)). 

I couldn`t provide any further evidence, I rarely venture further than my back door.  I`ve highlighted points that were covered in my PIP2 but I`ve set them out in such a manner they cover:

Safety

Time taken to walk a distance

Walking to an acceptable standard (or not, when suffering with significant pain)

Whether the activity could be repeated or not within a reasonable time

Time will tell.  But from various posts both on Scope and "Benefits and Work", I`m not expecting a change in the mobility component.

Thank you,

Andy

Cartini

Username_removed said:

Thanks for the update. It’s amazing how many of these threads just die so it’s good to know where things are up to. I wouldn’t read too much into an MR outcome given that the success rate is about 36% and falling. It’s essentially random. 

Hello Mike, thank you for your reply.  Whichever way it goes, I will update again.

Andy

Cartini

Good Evening everyone,

Another update.

Today I received the letter informing me of the result of my MR.  Unsurprisingly there was no change (as Mike mentioned earlier about the low prospect of it changing).

What has astounded me is this comment by the DM: "You report your asthma is well controlled, this means you can walk 200m".  My points remain at 4 because of this.

Neither the assessor nor the DM for the original "award" mentioned asthma.  My asthma is well controlled, and I didn`t apply for PIP because of asthma.  This 2nd DM has completely ignored all comments about my spinal condition, the pain it causes and the impact it has on my daily activities.

I`m now considering an appeal.  In my simplistic world I have nothing to lose because I`ve been informed that it will be made clear if my appeal will not be successful thus giving me an opportunity to withdraw.

Andy