PIP Fraud Investigation - Case Review Team Outcome
Hello everyone,
I posted on here before about a fraud investigation for PIP, just wanted to post and update and gather thoughts or feedback.
I have had a Social Services Care package for 3 years 25 hours care a week.
As previously mentioned I have ADHD, Autism, FND, Anxiety, Chronic Paid, PTSD. It can be quite intermittent, one day semi-mobile to the next day immobile for months.
They have given me the evidence and a decision.
The surveyed me for 4 weeks and witnessed me 10 times walking and using my car, even commenting on my driving ability as they followed me. One if the times they followed me they witnessed a panic attack, but noted this was an act as I was probably aware they were following me (total rubbish). They also noted the use of no wheelchair, which is true as I don't use it 24/7 only during frequent relapses.
They took my bank statements for four years and concluded that I went on holiday two times and that I did this independently with no support and stated "can obviously be independent in another country". They also concluded that I do leisure activities (which is true with support) such as go cinema, out for dinner, and to a pub.
They also said that I was able to attend the office two times (which they mandated as I work for them).
They note I don't look "autistic, anxious or stressed".
They noted I have a lot of transaction on my account? Yes, I do spend my wages?
They said I don't own a wheelchair, despite sending them the NHS Wheelchair Service documents.
They said I have no home mobility aids, despite sending the OT referral and purchase orders.
They sent Police into my flat, who without telling me, recorded me via bodycam footage, and said that I was able to put my shoes and coat on (as they forced me to go with them otherwise they'd arrest me). Said that I could leave the property, again which they forced me to into a police care, or face arrest".
I posted a picture two years ago on Facebook of a Yorkshire Pudding and therefore I can manage my own nutrition and cook independently.
They got my reasonable adjustments at work and stated that I didn't need them that I was able to concentrate and not have sensory issues (how is it ever possible to make that judgement)?
They have received a Neurologist Report, Social Services Report, GP Letter, Autism Service Report, Psychiatrist Report, Occ Therapy Report, ADHD Services Report, NeuroPhysio Report and mentioned none of it and concluded that on the balance my needs are misrepresented.
Therefore I have never been entitled and owe them £36, 000.00 and will be subject to criminal prosecution.
I cannot explain to begin how wildly crazy this is, and the distinct ignorance of evidence, of a fluctuating need and masking behaviours. It's full of assumptions based of a picture or a transaction.
I've requested an MR but the evidence is the evidence I sent already? It literally is crystal clear.
Any thoughts? Ideas?
Comments
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Hi @UDE604. This all sounds incredibly stressful. How are you coping?
I would suggest going to tribunal and go over everything that they have claimed and make notes that explain why they are wrong so you're prepared for their questions. You already seem to have a lot of evidence but is there anything else you could get?
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If im honest, pretty devastated and tearful. I didn't claim PIP for years even though I was entitled, and I claimed when I became really poorly and had additional care costs.
It's heartbreaking to see your disabilities diminished so quickly on the basis of circumstantial evidence-
I have contacted every provider, every service, every team I use for a Subject Access Request and im going to offset every single comment with evidence.
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I'm so sorry that it's making you feel so awful. It's incredibly intrusive and awful to have them say your disabilities aren't as bad as they are. That's great that you're going to gather so much evidence. I really hope that they change their decision.
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This must be so awful for you. Have I read this correctly that you work for DWP and they have investigated you. How on earth has this come about. My heart goes out to you.
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Hi.
Your situation sounds incredibly stressful, and I can see why you feel overwhelmed reading that decision. I would feel the same.
A few important things to keep in mind:
Surveillance doesn’t automatically prove fraud.
Short observations (like being seen walking, driving, or going out) don’t show what you are like the majority of the time. PIP is based on reliability (can you do something safely, repeatedly, to an acceptable standard, and in a reasonable time) not whether you can do it occasionally.
Fluctuating conditions are often misunderstood.
What you’ve described (good days vs long periods of being immobile) is exactly the kind of thing that should be assessed over time. Decision makers very often get this wrong, especially if they focus on isolated snapshots.
Ignoring medical evidence is definitely challengeable.
If they’ve genuinely failed to engage with reports from your neurologist, GP, OT etc., that is something you can challenge. They are supposed to weigh all evidence, not just surveillance.
The amount and fraud allegation raises the stake considerably.
A £36k overpayment + possible prosecution is not something to handle alone. At this point, you should strongly consider getting specialist advice urgently.
You could contact:
Citizens Advice
A welfare rights adviser or solicitor with experience in benefit fraud cases.
Mandatory Reconsideration (MR) needs to be structured.
Rather than resending the same evidence, it usually helps to:
Go point-by-point through their decision.
Explain why each assumption is wrong.
Link it back to the PIP criteria (reliability, frequency, support needed)
Highlight where they’ve ignored medical evidence.
Lastly I would be very careful about what i share publicly.
Given they’ve already used social media posts as “evidence,” it’s worth tightening privacy settings for now.
It might be that the DWP believe there’s a pattern of inconsistency but from what you’ve written, there are also potential red flags in how they’ve interpreted evidence. The key now is responding in a structured, evidence-led way rather than assuming they’ve already decided so nothing can change. I hope everything works out for you and please keep us updated if you feel up to it. Take care
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You'd think the DWP would look after "their own", apparently not.
[edited by moderator - language]
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