Just had a thought regarding short awards

Mark8699

Hello,

Just had a thought about short term ESA and PIP awards when they say the review is 12 months or 18 months. 

So you have a health condition but they say they’re maybe a functional change. So functional change means you’re able to cope with your condition or disability better. 

So for instance if you need CBT but it fails and you move onto I don’t know counselling. And that fails. But you then move into like a psychologist etc. 

Point I’m trying to make is does the law protect you from trying to get better with your conditions so at the point of review you can say you’ve improved etc. 

Or would that be seen as benefit fraud if you’re improving and claiming benefits as you’re progressing closer to your review date. Is there some kind of protection by law for this kind of stuff?

Because I know some of the members have said slight changes etc do not need to be reported and so on but I can’t help but think as soon as you notice the slightest bit of improvement you’re not entitled to the benefits you’re receiving. 

I’ve even started setting aside money incase they ask for an overpayment. Call me paranoid but I feel like the system is set up to penalise people for getting better and coming off benefits. Rather than giving people benefits to get better then come off them when it’s necessary. 

Cartini

Mark8699 said:

I can’t help but think as soon as you notice the slightest bit of improvement you’re not entitled to the benefits you’re receiving. 

Hi,

I disagree with your reasoning.

I`ve recently had my pain relief medication changed to Meloxicam; it hasn`t stopped the pain, but for simple things like cleaning my teeth it has eased it a bit.

I still have lumbar & cervical spondylosis and lumbar stenosis; medication will never cure those.  I`m still in pain when I walk, which is relieved when I lie down.

Does Meloxicam justify having my PIP stopped?  I don`t think so because, like many other medications, it has side effects - 2 of which are an increased risk of stroke or heart attack.  Should the other side effects be too much for me, I`ll just stop taking the medication which means I`m back to square one with unbearable pain when cleaning my teeth.

Mark8699

Cartini said:

Mark8699 said:

I can’t help but think as soon as you notice the slightest bit of improvement you’re not entitled to the benefits you’re receiving. 

Hi,

I disagree with your reasoning.

I`ve recently had my pain relief medication changed to Meloxicam; it hasn`t stopped the pain, but for simple things like cleaning my teeth it has eased it a bit.

I still have lumbar & cervical spondylosis and lumbar stenosis; medication will never cure those.  I`m still in pain when I walk, which is relieved when I lie down.

Does Meloxicam justify having my PIP stopped?  I don`t think so because, like many other medications, it has side effects - 2 of which are an increased risk of stroke or heart attack.  Should the other side effects be too much for me, I`ll just stop taking the medication which means I`m back to square one with unbearable pain when cleaning my teeth.

I do apologise. 

I’m talking more in terms of mental health. The previous two paragraphs explain and go into my reasoning. 

Cartini

Mark8699 said:

Cartini said:

Mark8699 said:

I can’t help but think as soon as you notice the slightest bit of improvement you’re not entitled to the benefits you’re receiving. 

Hi,

I disagree with your reasoning.

I`ve recently had my pain relief medication changed to Meloxicam; it hasn`t stopped the pain, but for simple things like cleaning my teeth it has eased it a bit.

I still have lumbar & cervical spondylosis and lumbar stenosis; medication will never cure those.  I`m still in pain when I walk, which is relieved when I lie down.

Does Meloxicam justify having my PIP stopped?  I don`t think so because, like many other medications, it has side effects - 2 of which are an increased risk of stroke or heart attack.  Should the other side effects be too much for me, I`ll just stop taking the medication which means I`m back to square one with unbearable pain when cleaning my teeth.

I do apologise. 

I’m talking more in terms of mental health. The previous two paragraphs explain and go into my reasoning. 

No problem.  I`ve been following your thread; I responded from a physical point

Mark8699

Cartini said:

Mark8699 said:

Cartini said:

Mark8699 said:

I can’t help but think as soon as you notice the slightest bit of improvement you’re not entitled to the benefits you’re receiving. 

Hi,

I disagree with your reasoning.

I`ve recently had my pain relief medication changed to Meloxicam; it hasn`t stopped the pain, but for simple things like cleaning my teeth it has eased it a bit.

I still have lumbar & cervical spondylosis and lumbar stenosis; medication will never cure those.  I`m still in pain when I walk, which is relieved when I lie down.

Does Meloxicam justify having my PIP stopped?  I don`t think so because, like many other medications, it has side effects - 2 of which are an increased risk of stroke or heart attack.  Should the other side effects be too much for me, I`ll just stop taking the medication which means I`m back to square one with unbearable pain when cleaning my teeth.

I do apologise. 

I’m talking more in terms of mental health. The previous two paragraphs explain and go into my reasoning. 

No problem.  I`ve been following your thread; I responded from a physical point

Do you see where I’m coming from in terms of a mental condition though? 

What’s the scope and protection from law?

key terms: reliably, repeatedly etc. 

Cartini

Mark8699 said:

Cartini said:

Mark8699 said:

Cartini said:

Mark8699 said:

I can’t help but think as soon as you notice the slightest bit of improvement you’re not entitled to the benefits you’re receiving. 

Hi,

I disagree with your reasoning.

I`ve recently had my pain relief medication changed to Meloxicam; it hasn`t stopped the pain, but for simple things like cleaning my teeth it has eased it a bit.

I still have lumbar & cervical spondylosis and lumbar stenosis; medication will never cure those.  I`m still in pain when I walk, which is relieved when I lie down.

Does Meloxicam justify having my PIP stopped?  I don`t think so because, like many other medications, it has side effects - 2 of which are an increased risk of stroke or heart attack.  Should the other side effects be too much for me, I`ll just stop taking the medication which means I`m back to square one with unbearable pain when cleaning my teeth.

I do apologise. 

I’m talking more in terms of mental health. The previous two paragraphs explain and go into my reasoning. 

No problem.  I`ve been following your thread; I responded from a physical point

Do you see where I’m coming from in terms of a mental condition though? 

What’s the scope and protection from law?

key terms: reliably, repeatedly etc. 

I can`t comment on anything to do with mental conditions; this is why I`ve been following your thread (and one or two other threads to do with mental health), so that I can understand more about something that doesn`t affect me (that I`m aware of).

poppy123456

Mark8699 said:

Point I’m trying to make is does the law protect you from trying to get better with your conditions so at the point of review you can say you’ve improved etc. 

There's no such law. When it's review time you simply fill in the forms as a new claim, so you tell them everything about how your conditions affect you.

There's no difference between mental health conditions and physical conditions, the same applies to both.

Mark8699 said:

Because I know some of the members have said slight changes etc do not need to be reported and so on but I can’t help but think as soon as you notice the slightest bit of improvement you’re not entitled to the benefits you’re receiving. 

Yes, that's correct. Has as been advised several times across different threads, you do not need to report all changes. If everyone reported all those small changes then the backlogs would be even longer than they are now.

Mark8699 said:

Or would that be seen as benefit fraud if you’re improving and claiming benefits as you’re progressing closer to your review date. Is there some kind of protection by law for this kind of stuff?

Benefit fraud? that's a little extreme. There's no protection law.

Mark8699 said:

I’ve even started setting aside money incase they ask for an overpayment.

That's quite extreme. You won't need to repay anything back to them. If at review the decision changes then that new decision starts from the date it's made. This will then overrule your previous award.

There's really nothing further to add than what's already been said across many many different threads.

racyguy

I had this issue when claiming DLA (High care & Mobility) a few years ago.
One of my conditions was a mental health problem - (PTSD).
After working with the health professionals, my psychiatrist and attending a day care facility together with a changed medication regime I started to see the wood from the trees.
I still had good and bad days but on the whole more good than bad.
I cancelled the DLA award (2003) because I could see some level of improvement and hoped that it would improve more over time.
However by 2011 I had a setback, a bad one that saw me being sectioned. By 2012 I was advised to reclaim DLA.
So you can move on and off benefits depending how you are. It would have been wrong to continue the claim for those 7 years as I could see an improvement.  
I currently claim PIP (Enhanced for both) 
but as the level of stress is now reducing due to in the main to not claiming any means tested benefits I am weighing up in my mind to decide at which point I should close the PIP claim down. 
Benefits should not be a way of life but something that you claim at various points when the floor drops off beneath you once again. 

Mark8699

racyguy said:

I had this issue when claiming DLA (High care & Mobility) a few years ago.
One of my conditions was a mental health problem - (PTSD).
After working with the health professionals, my psychiatrist and attending a day care facility together with a changed medication regime I started to see the wood from the trees.
I still had good and bad days but on the whole more good than bad.
I cancelled the DLA award (2003) because I could see some level of improvement and hoped that it would improve more over time.
However by 2011 I had a setback, a bad one that saw me being sectioned. By 2012 I was advised to reclaim DLA.
So you can move on and off benefits depending how you are. It would have been wrong to continue the claim for those 7 years as I could see an improvement.  
I currently claim PIP (Enhanced for both) 
but as the level of stress is now reducing due to in the main to not claiming any means tested benefits I am weighing up in my mind to decide at which point I should close the PIP claim down. 
Benefits should not be a way of life but something that you claim at various points when the floor drops off beneath you once again. 

Yeah 7 years is a long time to keep claiming for something that’s slightly improved. 

What about if the review was 3-6 months away. Would you start the process now?

poppy123456

Improvements in a health condition doesn't mean you're no longer entitled to any of the benefits you're claiming.

Mark8699 said:

What about if the review was 3-6 months away. Would you start the process now?

You were advised this on another thread.

racyguy

Mark8699 said:

Yeah 7 years is a long time to keep claiming for something that’s slightly improved. 

What about if the review was 3-6 months away. Would you start the process now?

You are required to notify the DWP at any time if you have any improvement that could mean that you are no longer entitled to PIP.

poppy123456

racyguy said:

Mark8699 said:

Yeah 7 years is a long time to keep claiming for something that’s slightly improved. 

What about if the review was 3-6 months away. Would you start the process now?

You are required to notify the DWP at any time if you have any improvement that could mean that you are no longer entitled to PIP.

IF being a big word here. Not all changes need to be reported. There's some people that think that they need to report changes for every single thing and that's not the case.

racyguy

poppy123456 said:

racyguy said:

Mark8699 said:

Yeah 7 years is a long time to keep claiming for something that’s slightly improved. 

What about if the review was 3-6 months away. Would you start the process now?

You are required to notify the DWP at any time if you have any improvement that could mean that you are no longer entitled to PIP.

IF being a big word here. Not all changes need to be reported. There's some people that think that they need to report changes for every single thing and that's not the case.

I agree and you have to use some common sense. For a mental health issue you need to ask yourself if you are more able to have a more normal life now than you had when you claimed the benefit.
And there are people that continue to claim PIP/DLA even though there is an improvement but think that they may go downhill at some point in the future so don't see the point of stopping the claim and then starting a new one up at some point in the future. 

Mark8699

racyguy said:

poppy123456 said:

racyguy said:

Mark8699 said:

Yeah 7 years is a long time to keep claiming for something that’s slightly improved. 

What about if the review was 3-6 months away. Would you start the process now?

You are required to notify the DWP at any time if you have any improvement that could mean that you are no longer entitled to PIP.

IF being a big word here. Not all changes need to be reported. There's some people that think that they need to report changes for every single thing and that's not the case.

I agree and you have to use some common sense. For a mental health issue you need to ask yourself if you are more able to have a more normal life now than you had when you claimed the benefit.
And there are people that continue to claim PIP/DLA even though there is an improvement but think that they may go downhill at some point in the future so don't see the point of stopping the claim and then starting a new one up at some point in the future. 

So if you haven’t CONSIDERABLY improved, is it reasonable to continue your claim?

bg844

Yes.

Mark8699

The way to look at it according to PIPP professionals is over a 3 month period have you improved that you can do the descriptors apparently 

poppy123456

What matters is at least 50% of the time over a 12 month period. If you can't complete that activity regularly, reliably, to an acceptable standard then you're classed as not being able to complete it at all.

racyguy

Mark8699 said:

So if you haven’t CONSIDERABLY improved, is it reasonable to continue your claim?

The word 'considerably' is not used in the regulations.

Mark8699

racyguy said:

Mark8699 said:

So if you haven’t CONSIDERABLY improved, is it reasonable to continue your claim?

The word 'considerably' is not used in the regulations.

What word is used then?

racyguy

poppy123456 said:

What matters is at least 50% of the time over a 12 month period. If you can't complete that activity regularly, reliably, to an acceptable standard then you're classed as not being able to complete it at all.

It's 9 months going forward and not 12. The other 3 months are in the past.
That does not mean to say that you have to wait those 9 months - the test is to say that is it more likely than not that it will last those 9 months.
So if you think it more likely that the improvement will last for another 9 months then you are required to notify this to the DWP. Obviously this will cause a new assessment to take place or if you think that the improvement will last more than the next 9 months you should close the claim down.

poppy123456

racyguy said:

poppy123456 said:

What matters is at least 50% of the time over a 12 month period. If you can't complete that activity regularly, reliably, to an acceptable standard then you're classed as not being able to complete it at all.

It's 9 months going forward and not 12. The other 3 months are in the past.

Which is why i didn't state 9 months going forward. The 12 months i referred to was in total.