CAPITA UNFAIR PRACTICE DLA TO PIP ADVICE PLEASE..
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Jazz wrote: My husband has sadly suffers numerous conditions. CFS, Angina, Sleep Apnoea, Angina, Degenerative Disc disease to name but a few. To add to all of this he suffered with back problems on and off for 26 years up until May 2013 when things went drastically wrong. In May 2013 after 18 months of continuous back problems that were worsening with time despite physiotherapy, particularly between Dec 2012 and May 2013.
Eventually in May 2013 he suffered a major central disc prolapsed which the ambulance service failed to recognise, leaving my husband on the floor of our living room for 14hours, with a bottle of Morphine. Despite numerous call for an Ambulance that day including two separate paramedics coming and going an Ambulance never came to collect my husband until 21.45 and he never reached hospital until 22.30. In A&E a doctor told him he had to be transferred to another Hospital 2hrs away that had a spinal unit as he needed an emergency spinal operation as there were a group of nerves being crushed. That said he was put on a ward without transfer and forgotten about for another two days. . The Spinal Surgeon said that the pain that my husband endured was equal to that of a soldier having his legs blown off.
As a result my husband is now doubly incontinent and has severe irreversible nerve damage to his saddle area legs and feet. He has no feeling in his feet, therefore is unable to stand still on standing as he has no balance, similar to that of a clown on stilts who has to continually move from one leg to another. He has falls, and it at constant risk of going over. Due to the balance problems he cannot carry things and use his crutches, even if he tries to using one crutch it throws him off balance. He is in constant pain can't stand without it causing him heightened pain, let alone walk without pain. He has a void in his saddle area, so cannot tell if he is sitting on something or not, it feels to him like he is sitting directly on his spine, he can miss a chair seat easily as he cant feel it with his saddle area. He is in pain 24/7, never has a good day, only worse days. He has asked the GP if he can have his feet cut off due to the pain. Of course the GP said no, because it is nerve pain, even if his feet were removed he would still feel the pain. Since surgery he has involuntary twitching of his arms and legs. Has involuntary bowel movements and both stress and overflow incontinence of the bladder and bowel. He is on so much medication the GP and Pain Specialist say cant have anymore, he has tried everything in Pain Management nothing works. He has severe depression because he now has theses difficulties and is only 45 years old. The combination of his conditions, his medication and the depression causes him to sleep an awful lot and he forgets to take his meds.
He has to have help with showering, dressing below the waste, cant cook or prepare a meal, cannot walk any distance without severe pain or risk of falling, has to be prompted to eat, and take meds and to drink enough. If he does not drink enough he gets bladder infections and has been hospitalised for this. He needs help to manually evacuate his bowel and often has vaso vegal attacks when he has to catheterise. He avoids going anywhere in case of incontinence
On top of all of this I have chronic Fibromyalgia, and relied on my husband to do most things for me prior to May 2013 so now we really struggle with day to day living.
My husband was on DLA High, High and his initial award was until June 2015. then on 22 JAN he was sent a PIP form, which using your brilliant guides will filled in and returned with 9 extra pages. We listed numerous people that the DWP could write to with regard my husbands conditions. We asked that if it was necessary to have a face to face assessment, could we have a home visit from someone suitably qualified to understand the complications of 'Cauda Equina' and nerve damage.
On THURS 19th FEB we returned it 'signed for' and on MON 23rd FEB the DWP signed for it.
On the afternoon of TUES 24th FEB we had a missed call from a withheld number. I suspected it to be the DWP as we are ex-directory, are registered with the TPS and only a handful of friends and family have our number, non of which would withhold theirs.
On WED 25th FEB we had a phone call from 'Capita' which I answered as my husband was sleeping, on explaining, Capita said they would phone again in the evening, which they did. Capita told my husband that they were coming out to do a face to face assessment on TUES 3rd MARCH at 12.45. my husband wrote it down in the diary. I pointed out to my husband that the appointment was a little early in the day to give us both time to wake (extremely difficult for both of us) and deal with bowel management etc.
On FRI 27th FEB we received a letter from CAPITA dated 24th FEB telling us that my husbands case had been referred to them and that a face to face assessment could take between 12 and 16 wks. I looked at the CAPITA website and it says clearly that you can change an appointment once if the appointment is not at a suitable time. My husband phoned CAPITA, and explained that the appointment was to early in the day for him. The man that he spoke to told him that 12.45 they do not do appointments later than 12.45. My husband explained that he was worried that he may still be asleep that time of the morning (12.45 is morning to us with our sleep problems) and the man replied that 12.45 is not the morning it's the afternoon. he said that if the assessor turns up and we are asleep they would class it as 'we did not attend' and that my husbands payments would stop. My husband explained the difficulties again and the man said that there were no more appointments in the diary open after 3rd MAR and said all we could do, is phone back on MON 2nd MAR.
On MON 2nd MAR my husband phone CAPITA, went through the security checks and he asked them to speak with me. this time we were speaking to a lady. I explained our difficulties and what her colleague had said on FRI 27th FEB and she replied ''ill have a look at the diary, we do appointments up until 2.30pm each day", She then came back and said "Sorry we don't have any later appointments". I told her that her colleague said some more appointments would open up on MON 2nd MAR and she replied "yes, I have a lot of days open for appointments, but none for a time later than 12.45, 12.45 is the latest". So that was that, CAPITA say you can change your appointment, but the truth is 'not if it doesn't fit in with the assessor being in your area on a particular day'.
On TUES 3rd MAR the assessor came. She never showed any ID and neither did she ask to see my husbands ID. it wasn't until some way into the assessment, or should I say interrogation that she told us her name, and that was only because my husband was getting fed up with her rattling on and ignoring him, he had to say 'What's your name', because he was trying to get her attention as she would not listen to him. and then she didn't answer straight away. I was trying to give her 46 extra pages of evidence, but she refused to take it. She asked leading questions, sometimes 3 questions at a time and every time my husband tried to answer she spoke over him giving the answer to her own question in her own words. this went on for a whole 1 hour 4o minutes. I could see what's she was doing, the DWP had trained her well, and at times I had to interrupt as she was confusing things to get the answers that she wanted. Every time my husband tried to tell her things in his own words, she would change the subject and kept referring to back ache, far from the disabling condition that my husband suffers.
The assessor even referred to a complaint that my husband didn't mention in his PIP claim (Carpel Tunnel Syndrome) it was mentioned some time ago (2 years) in his ESA claim and nearly 2 years ago in his initial DLA claim for Cauda Equina, but since he has had the worst hand operated on. He didn't mention this condition in the PIP claim as the Cauda Equina Syndrome is the main disabling condition.
The assessor had a lot to type into her laptop when she was asking my husband questions that she then went on to answer herself and when my husband did get a word in edgeways to try and tell her things, she typed nothing at all.
During the whole interrogation the assessor is asking leading questions, not letting my husband give his own answers. The assessor continuously blocked my husband answers throwing in another question or statement to try and manipulate the way he replied. The assessor was not interested in what my husband was trying to say. The assessment was not a two way a conversation whereas the assessor was trying to understand how my husbands disability impacts on his daily life ,it was being led and directed by the assessor to distort the findings to an outcome unfavourable to my husband.
We taped the whole interview with a digital dictation machine which even captured the assessor using the 'F' word.
After the assessor left on TUES 3rd MAR we received through the post a letter dated 26th FEB confirming the appointment that we had just had.
Can anyone advise where we go from here please?
Best Wishes
Hi J,
Welcome to the forum !!
It would seem that The Capita Assessor was rather unprofessional !
The letter that you received from Capita informing you of a possible 12-16 week wait for an assessment seems to be being sent out as standard, so they were probably unaware that you had an appointment for a F2F on 03/03/15.
You seem very organised, and this can only be a good thing !
The report compiled by The Capita Assessor will have been sent to The DWP PIP Decision Maker (Case Manager) who will make the final decision.
You can contact the PIP Helpline for an update :
PIP helpline :
Telephone: 0345 850 3322
Textphone: 0345 601 6677
Monday to Friday, 8am to 6pm
Once you receive the decision, if it is adverse, you can challenge it by requesting a Mandatory Reconsideration. (MR)
Whilst in contact with the PIP Helpline, you could also request a copy of The PIP Assessors Report, although they may not provide copy of this until after a decision has been made.
As a separate issue if you are unhappy with the quality/accuracy of the PIP Assessor's Report when you receive it, and/or felt that their behaviour was beyond the pale, you could also make a complaint to Capita : This email address is being protected from spambots. You need JavaScript enabled to view it.
You could complain now, or wait until you have received copy of the report, and/or have received a decision from The PIP DM.
You should be aware that even if you totally discredit the Capita Assessor and their report, that this would not give you a correct PIP Award, although it may help if you have to request an MR.
The most that you could hope for is an apology from Capita, and maybe a fresh F2F carried out by a different Assessor.
Quite a lot of members have thought that a F2F has gone really badly, only to receive a correct decision as a result of the F2F.
The Assessor should certainly not be swearing !!
"After the assessor left on TUES 3rd MAR we received through the post a letter dated 26th FEB confirming the appointment that we had just had."
This happens quite a lot as well.
They are supposed to give you 7 days written notice of a F2F appointment.
However, this 7 days will run from the date of the letter, rather than from the date of your receipt of it.
They would probably say that you accepted and agreed to a short notice appointment over the phone, in which case the 7 days notice is not necessary.
You could also complain to your M.P. at whatever stage you think fit :
Contacting your MP
Please keep us updated, and we will advise further, as appropriate !
N.B. F2F = Face to face assessment.
bro58
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Thank you so much for the very quick reply
[The report compiled by The Capita Assessor will have been sent to The DWP PIP Decision Maker (Case Manager) who will make the final decision.
We have already had a decision, 'standard rate' care and 'standard rate' mobility.
As my husband is unable to walk 'safely' within a 'reasonable time' as 'often as it is required' due to his pain and loss of balance he wishes to challenge the decision with regard to mobility. He relies on his car as we do not live anywhere near a bus route, our doctors is a 20 mile round trip, hospital the same, his spinal hospital 2hrs away by car and on an average day he has difficulty even walking to our bathroom (ground floor wet room fitted by adult social care)
With regard to his care, points were not awarded where points should have been, and if they had been he would have been eligible for the 'enhanced rate' care.
Once you receive the decision, if it is adverse, you can challenge it by requesting a Mandatory Reconsideration. (MR)
It is my husbands intention to request a MR.
It can be clearly heard on the digital recording that the Capita Assessor refused the extra 46 pages information offered (some of which was an Expert Witness Medical Report of my husbands condition and prognosis supporting that his condition is permanent). She said we are allowed to look at one letter.
We sent the 46 pages recorded delivery to the DWP, which they signed for on the morning of 16th MAR. We then received the Decision Notice in a letter dated 17th MAR. I do not believe that the 48 pages of supporting evidence were read and considered before the Decision Notice was sent, if it had been, the Decision must have been different.
It is also heard on tape that I help my husband shower as he cannot do it alone safely and he was awarded 2 points for using an aid (He never mentioned an aid).
My husband told the assessor that he had been under the care of the mental health team but was only allowed to have 12 sessions due to funding and he was told to go back to his GP to be re-referred. He told the assessor that his GP said there has to be a time lapse before re-referral and that he was awaiting a re-referral, the assessor butted in and abruptly relied, "No that's not right 'cause there is Cognitive Therapy, Analytic Therapy, Behavioural Therapy, Cognitive Behavioural Therapy". She claimed to have been a nurse for 20 years, but what type of nurse I do not know. I don't think she should have been making such statements.
What was obvious about this former nurse, was that she did not understand my husbands neurological condition or Cauda Equina in the least.
It can be heard on tape that my husband does not prepare or cook food, and that he has microwave meals that are prepared and cooked for him if I am well enough or we eat at a nearby café that does good home cooked meals with fresh veg etc. for £4.50 - £5, the same cost as a micro meal, he was awarded 2 points for using an aid (he never mentioned an aid). In the tape the assessor tries to speak over us (which she kept doing throughout the assessment) saying
"its good that you go out, 'cause that's something to look forward to and you enjoy your meals and it's only 4 miles down the road, and you know you've only got a 20 meter walk from the car park in". (her words not ours)
She was told "No its not even that far , we park right outside the door and sit right next to the toilets for incontinence reasons", the assessor admits to knowing the café which sits off the road and has its own massive car park. We step out of our front door into the car that is 1 metre away, drive 4 miles along the lane that we live on, and step out of the car into the café.
Throughout the assessment the assessor told my husband what he can do, how he does things etc. If she did ask questions, 'she' answered them and would skip from one subject to another if my husband tried to tell her things in his own words,. The whole assessment was disgraceful.
When we ask for a MR, do we tell the DWP how the assessor carried on and that we recorded it?,
or,
do we just tell the DWP we think that they have made the wrong decision and on which descriptors?
At the end of the day, the DWP DM can only make a decision on what the assessor has recorded, and if, the assessor has recorded the wrong information, the DM can only come to a decision based on that wrong information.
Whilst in contact with the PIP Helpline, you could also request a copy of The PIP Assessors Report, although they may not provide copy of this until after a decision has been made
We will request a copy of The PIP Assessors Report. Is it worth telling the DWP that we are have requested a copy of The PIP Assessors Report?, and will they DWP allow us time extra time with the MR to receive it?
We have contacted my husband GP for further medical records, I don't know how long these will take.
As a separate issue if you are unhappy with the quality/accuracy of the PIP Assessor's Report when you receive it, and/or felt that their behaviour was beyond the pale, you could also make a complaint to Capita
We will be making a complaint against The Capita Assessor, as she was very manipulative and dictating during the assessment. I really feel that other claimants will be at a disadvantage if this lady is sent to assess them.
They would probably say that you accepted and agreed to a short notice appointment over the phone, in which case the 7 days notice is not necessary.
Normally when people make appointments, both parties mutually agree an appointment. My husband is of a delicate state of mind and is awaiting further therapy from the mental health team. when Capita phoned him, they told him an appointment has been made for 3rd MAR and that Healthcare Professional would be visiting. He was not in the right state of mind to realise that he could have said that the time was not suitable.
Best Wishes
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I am sorry, I was not aware that you had already received a decision !
As you probably know, you have one month from the date of the Decision Notice to make your formal written request to The DWP for an MR.
See : PIP MR/Appeals Guidance.
Mandatory Reconsiderations Explained
Disability Rights UK Factsheet - Appeals and Mandatory Reconsiderations.
&
Sending Documents to the DWP or ATOS
You may well be aware of the above already, but I have to assume that you are not !!
Even if you are awaiting documentation, you should make sure that you submit your MR within the one month deadline to protect your rights.
You can include all the arguments, and evidence that you have at the time of posting, and inform them that you are awaiting further documentation/evidence, and will forward that on to them as soon as you have it.
There is of course some risk to an existing award when an MR is requested in that the DWP Decision Maker will re-look at both award afresh, and there is a chance that the existing awards could be reduced.
In reality, this does not happen very often, if it did, you could appeal that adverse MR decision to The Tribunal Service. (TS)
You need to risk assess this in that did hubby only scrape in with the Standard Awards ?
Did he only receive the requisite minimum 8 points ?
How substantial is the evidence that he should have scored 12 points ?
How well can you present his challenge ?
All these aspects should be considered, and I am afraid that I cannot advise on whether you should request an MR or not, that is a decision that only you make.
With respect to The MR to the DWP, concentrate on reiterating where and how you feel that your hubby should have scored points, and cross-reference to any eveidence that you have, even though you may have already provided it.
You can cross-reference to pages/evidence within the PIP 2 Form as well as any fresh evidence.
You should keep your references to the Assessor down to refuting and showing how their recommendations are errant.
e.g. The Capita Assessor stated xxxxxxxxx, even though we told them xxxxxxxx, and provided evidence confirming xxxxxx at xxxxxxxx.
Or something similar.
So with the MR your main aim is to make it clear how and why your hubby should have received Enhanced Awards. (As stated you can reference the Assessor)
Try and keep your submission as brief and to the point as possible, using bullet points and referencing the actual PIP Descriptors as applicable.
The easier that you make it for The DM to see that you have a valid challenge, the more chance of success.
You can mention that you have made a complaint to Capita as well if you wish, but try and keep that as a separate issue.
You are allowed to covertly record an assessment for your own reference purposes, but if you are going to try and use this as evidence, you would have to write a verbatim transcript of the relevant extracts, noting the time when it occurred within the recording.
You may have to provide a copy of the full recording if asked to.
With respect to your Capita Complaint, you can mention everything with this !!
Although obviously, you do not have to prove to Capita that your hubby should have received Enhanced Awards.
They do not make the decision, they only make "recommendations" !!
"At the end of the day, the DWP DM can only make a decision on what the assessor has recorded, and if, the assessor has recorded the wrong information, the DM can only come to a decision based on that wrong information."
The DWP DM is supposed to take "ALL" evidence before them into account "including" the Assessors report "And" any evidence that the claimant has provided themselves, "including" The PIP 2.
Remember, the DM is not medically qualified, they will only look to see whether you score enough points with the relevant descriptors.
The DM should then make their decision "on the balance of probabilities"
You should request a copy of the The Capita PIP Assessors Report from the DWP, you can mention this in The MR, and they are "supposed" to allow you more time.
But I would not rely on that !!
Try and submit any evidence ASAP, there is no stipulated time with regards to how long an MR should take, I would try and have all your evidence in within a month or so of them receiving the MR request.
I am sure that you will put up a good challenge if you do decide to request an MR.
I am sorry if I have missed anything, but your post is rather long which sometimes makes it difficult for us to sift out the actual queries from other comments.
Please keep us updated.
bro58
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