PIP Review, I dont know what to do

Hi calesha

Welcome to the forum, you might want to have a look at the following FAQ which explains where everything is.

Welcome to Benefits and Work .

One of the first things is to understand the difference between DLA and PIP.

DLA looks at generic care needs in regard to bodily functions, PIP looks at the claimants specific ability to carry out an activity such as eating. DLA was awarded because the claimant needed an amount of care (in time) during the day, the night or both, to help them with that bodily function.

PIP looks at the claimant's ability to complete specific tasks within the activity and is points-based, these are clearly defined and it is easy not to score points because the claimant has not shown that they meet those specific criteria.

DLA treated the use of aids as a reason to reduce the amount of care needed, PIP treats aids as an indication of disability and in general they score extra points.

DLA's care need was reasonably generic, PIP treats prompting, assistance and supervision as different activities and as a result, they can score different points.

DLA required that the care was required for the majority of the time, for PIP it is the majority of days.

For PIP activities must be completed reliably, this means

• Safely – in a fashion that is unlikely to cause harm to themselves or to another person.
• To a necessary and appropriate standard – given the nature of the activity.
• Repeatedly – as often as is reasonably required.
• In a timely manner – in a reasonable time period.

Although DLA considers these terms, they are poorly defined as they are implemented through Case Law rather than being defined in the legislation as they are for PIP.

The first stage to challenging a Decision is for you to request a Mandatory Reconsideration, this needs to be done in writing to the DWP, within one month of the Decision, to the office that dealt with your claim, have a look at our PIP MR & Appeal guide for details of the process, the PIP area also has template letters that you can use to make the request with.

www.benefitsandwork.co.uk/help-for-claimants/pip

You should contact the DWP for a copy of the assessment report called a PA4 if you have not already done so, I would phone them but again follow up the request in writing. Once you have the assessment report you will have a better understanding of how the DWP Decision Maker has come to their conclusions and will then be able to argue against them.

I usually use a highlighter to highlight any inaccuracies, once you have gone through the report you then set out why you are applying for a MR and go through each descriptor one at a time why you disagree with the assessor and try and match it with any supporting documents you may have sent in.

Understand that the assessor is offering an opinion when they say that you can do the PIP activities, tackling these head-on is unlikely to be successful, you need to show that the basis of that opinion is founded on incorrect information, so try and refer to your evidence to undermine what they have said.

Also, try and stick to issues that lead to your scoring points, I often hear members referring to the assessors spelling, as an example, whilst it may show a lack of professionalism, raising it as an issue isn't going to help you get an award.

Your primary task is to show that you meet the criteria, there are many reasons you may have failed, you need to address each of these but don't get bogged down in criticising the assessment report unless you can clearly show that it is incorrect, it is a lot easier to argue the facts of the situation;

Lastly, make sure that you understand the criteria that you are being assessed against you can put the best case forward that is possible but you won't score points if you do not meet the PIP Descriptors.

If you apply for a mandatory reconsideration you can inform them that you agree with their findings and that you are not disputing the mobility component.

Come back to the forum if you need any further help.

Gary

Hi calesha,

I know this is all very worrying for you. Yes, there is a small risk that if you make an MR request you could risk losing your mobility award. However, this is a small risk. In my experience I have only had DWP review a case removing an award once, and this was in a very weird case anyway! However, even if DWP did remove your mobility award, there would be a right of appeal to the tribunal. If you need to appeal to tribunal, the tribunal can review the whole of an award, but if the tribunal was minded to reduce part of an award it would gave to give a warning so you could consider withdrawing your appeal. So, you see there is a risk, but it shouldn't put you off claiming benefit that you are entitled to receive.
I am sure that you have read posts on here and elsewhere stating that it is often quite difficult to get the correct level of benefit. Nevertheless if you continue to read, there are very few people you don't succeed in the end. I don't know why the stptstem is so difficult, but unfortunately sometimes it is just a question of following the process through.
You have been awarded 12 points for mobility, so this clearly shows a high level of disability. You haven't said whether this is a physical or mental health problem, or a combination. If physical, I suspect you will have problems getting in or out the bath and with dressing. If you have anxiety etc that means you need to be accompanied when going somewhere, this might dovetail with ot meeting people and socialising. So, it is entirely possible that the disabilities leading to mobility points will also be relevant to daily living. Have a good look again at the daily living descriptors and then match these to your disabilities. Be very critical, and work out the appropriate points. You can then write your MR letter. At the opening of your letter make sure that you state clearly that you do not dispute the mobility award, but then say that the assessor and/or decision maker (as appropriate) has taken X health condition into account for mobility but not for daily living. You can explain why in a couple of sentences if you wish. Then you can go through each daily living descriptor, stating that although DWP awarded X points, the correct value should be Y, and again explain in a couple of sentences. If the assessor has made errors or assumptions, briefly criticise these, maybe using a couple if bullet points, but don't go through each spelling error or cut n paste as your MR letter will be very long and will lack force!
If you have any medical reports send these in. If you sent them before, you could resend, and comment that you are sending them again as these were clearly ignored!

Try and stay positive. Some people find focusing on writing the best MR letter they can, is a good way to alleviate worry.

I hope this helps. Please do not give up!

LL26