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Better to claim in future or fight this one?

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7 years 2 months ago #180143 by Sorcerer
New to the forum so be gentle :)

My husband was receiving the lower care component of DLA and had to go for a medical assessment for PIP. Long story short, as you know, it takes 8 points to be eligible for PIP but he was awarded 7, so he missed out by one point. We were pondering whether to ask for Mandatory Reconsideration but before making a decision, something happened.

Looking back, my husband admits that he should have gone to the doctors a long time ago, because I've been telling him for months that he's been getting grumpier, short-tempered, withdrawn and generally acting out of character. In short, I think he's suffering from depression, but he either couldn't or wouldn't see it and so he didn't go.

Maybe missing out on a PIP award by just one point was the trigger or maybe it was something else entirely but things finally came to a head. He's self-employed doing computer repairs and he was dealing with a particularly difficult job on a customer's laptop when he suddenly picked it up, threw it across the room and ended up sat in a corner crying his eyes out.

I took him to the doctors myself and he was put on antidepressants and referred to the hospital mental health team. Mental health resources are very streched so anyone referred to them first has to be 'triaged' to make sure that a) they really do need help and b) that they can be helped. My husband 'passed' the triage and was deemed to be a good candidate so he is now on a waiting list to actually get his first appointment with a psychiatrist.

Because this happened before we had put in the request for a Mandatory Reconsideration, we decided to include this new information. He didn't include any mental health info in the original PIP application so he got zero points for that descriptor. Now, given this new information, we felt that maybe he should get a score for that descriptor so we included the letter in the paperwork for Mandatory Reconsideration.

The letter from the mental health team didn't really say anything because as yet, he hasn't even been seen. It was just proof that he has gone through a mental health assessment and that he is considered to be in need of treatment in this regard.

So, the MR went ahead and they have got back to us to say that nothing has changed. They uphold the original decision to award only 7 points and refuse PIP because we have presented no new information. They say that they have taken into account the information provided by the letter from your psychiatrist but as that letter only says he's on a waiting list and he hasn't even seen a psychiatrist yet, but will be seeing one when they can fit him in, makes us think that they haven't really considered it at all.

The question, finally, is - Should we go to appeal with this application or should we let this one die and make a new application when we have a proper diagnosis and treatment plan from the mental health team?

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7 years 2 months ago #180179 by Gordon
Sorcerer

Unless you can show that your husband was effected by this depression at the time that he was assessed, then it will be classed as a change and is specifically excluded from any MR or appeal. Basically they can only re-visit the Decision on the information that was or could have been available the time.

So have two options.

Appeal the existing Decision knowing that his latest condition will likely not be taken into account or make a new claim for PIP in which his current problems can be considered. Be aware that in both cases it is not the condition that will be considered, but the impact that it has on his ability to complete the PIP activities.

If he is unable to work have you looked at claiming ESA?

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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7 years 2 months ago #180209 by Sorcerer
Replied by Sorcerer on topic Better to claim in future or fight this one?
Thanks Gordon, that's very helpful. It looks like we'll probably be better letting this one go and maybe putting in another claim when he's actually receiving treatment.

He is managing to work a bit, but isn't capable of doing anywhere near his usual workload. As an example, if he normally does, say five or six jobs a day, he's currently managing to do just one or two. Working mainly in maintenance he has a very good, logical brain and usually works methodically through problems to diagnose what's wrong but currently, if things don't go to plan or if the slightest thing goes wrong, he can't see a way out of it, can't cope, and ends up either in a rage or in a corner crying.

Thanks again,
Susan

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