Relevance of a Diagnosis

Hi UC: Universal Compassion!
You are right PIP is bases on loss of function rather than what actually causes it. The trouble is that DWP like labels, it makes them sit up and listen! There is nothing wrong with saying 'I have backache and can't do XYZ PIP activities.' However, it doesn't sound very convincing. DWP like to read eg 'I have spondylolisthesis, and can't do...' I think part of the problem is that there is a guidance manual listing various diseases etc and next to it, it says 'likely to have problems with...'. I suspect that the generic backache entry won't have any obvious problems attached to it. It is therefore easier for the assessor just to say 'no diagnosis' go along the route of generic backache unlikely to give rise to PIP points, and leave it like that. I may of course be that insufficient training has been given to 'think out of the box' to investigate what the generic backache actually entails!
PIP is awarded 'if your ability to carry out daily living/mobility activities is limited/severely limited by your physical or mental health condition.' There is nothing that precludes generic backache, and that is clearly a health condition. (The quote is from the Welfare Reform Act 2012 s 78.)
You brother in law wishes to appeal - the first steps is to ask for mandatory reconsideration. Firstly go through the assessment report and try and group the criticisms into maybe 4 or 5 bullet points.
You have already made a good start. - one bullet point could be false assumptions - ie 'I drive I can do everything', secondly you could say about the lack of diagnosis. There might be other glaring errors, the assessor might have been rude, hasty etc etc.
He will need to open your letter, saying you are asking for DWP to reconsider whether enhanced rate daily Living and/or Mobility award should be made. (As appropriate.)
Start the letter with a paragraph or two about your illness, when it started, became worse, the overall effects etc. Include any informal diagnosis and whether you have any tests pending. Explain why no formal diagnosis has been made if you know.
Then write down you bullet point critique. Give examples from the report of the worse criticisms to illustrate each bullet point.
He may then wish to include a separate paragraph about driving. This is something that often comes up, and at the very top of the members forum is a post I wrote, that Gary kindly shared dealing with driving assumptions. Feel free to include all or part of this in your letter.
The third part of the letter - go through each descriptor - using the members guides can really help here - state what points should have been awarded and why. Remember that when 2 or more activities in a section apply equally the highest score should be awarded. Think about safety, reasonable time, repetition and acceptable standard - all of which must apply across the day as reasonably required. A better day won't preclude points if the majority pattern of days confirms points.
Good luck with brother in law's MR.
let us know how you both get on.
LL26

Hi UC: Universal Compassion!

If the Upper Tribunal case helps your brother in law then I would use it, if you look at the first post on the forum 'PIP and Driving' LL26 wrote a good post concerning PIP and driving which I though was well defined; www.benefitsandwork.co.uk/forum/10-dla-e...8543-pip-and-driving.

Now you have the assessment report you will have a better understanding of how the DWP Decision Maker has come to their conclusions and you will now 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 'in my opinion' 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., remember they are just an opinion which is not based on fact.

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.

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, halfway down the page; www.benefitsandwork.co.uk/help-for-claimants/pip

For the CRMR1 form to initiate your MR; www.gov.uk/government/publications/chall...ork-and-pensions-dwp

When you have a better idea of the issues with your claim, come back to the forum and we will do our best to help.

Gary