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The DM has ignored the variability of my condition

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6 years 10 months ago #188891 by nick h.
On my 'How your disability affects you form' I repeatedly referred to relapses in my condition. And I repeatedly stated that the combined duration of the relapses generally totals 6 to 8 months per year. MY GP's letter says I have relapses. My conditions, CFS and depression, are known to be variable for many patients - everyone in healthcare must be aware of this by now. The points I would score during a relapse would be very high. enough for the maximum rates in both PIP components. At the face to face assessment I was not having a relapse. I said I was having a good day and a good week. The assessor did not ask about relapses - presumably the software did not prompt her to ask about variability. My decision letter gives me the points applicable on my good day and makes no mention of relapses at all. There is just one mention of a 'bad day' in the context of one particular activity. I don't understand...why was variability ignored? Perhaps I should have ignored my good periods on the form and only described my relapses?

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6 years 10 months ago #188915 by Gordon
Nick
From your post you completed the form correctly, I'm afraid it is a regular occurrence on the forum for claimants to report that the "majority of days" or "reliably rules have been ignored by both the assessor or the DWP.

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 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.

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;

"the assessor recorded that I walked 50m, I did but they have failed to document that I had to stop every 10m for a rest due to breathlessness"

than their opinions

"based on my observations of the claimant walking I believe that they can reliably walk more than 200m.

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.

Gordon

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

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6 years 10 months ago #188933 by nick h.
Thanks very much Gordon, I'll get on it. The points breakdown in the decision letter reads as if the assessor gave a very fair assessment of me on the day. I think perhaps she did a pretty good job but couldn't dig deeper because of the boundaries set by the DM and the software. So perhaps it is heartening that I may not need to overturn the work of the assessor? If it goes to appeal I would hope the tribunal panel would see that the DM has made a basic error by only considering half of the information I provided.

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6 years 9 months ago #189952 by nick h.
I've received the assessor's report and I've decided to take the decision to appeal if necessary. I have 5 days before the deadline for requesting a mandatory reconsideration, which I'll do in a recorded delivery letter. From what I've read here, I don't mention my grounds in the letter, I just state that I want a reconsideration. Is that correct?

My grounds are that variability was not taken into account. The assessor didn't ask about relapses, although there's lots of detail about them on my form and they are mentioned in my GP's letter and my previous claims. And I didn't have the presence of mind to mention them at the assessment. I wasn't thinking very clearly so I answered all the assessor's questions according to how I was feeling on that day. So the incorrect decision is partly my fault. Might it help if I said this in my request for a reconsideration?

If I'm asked for evidence of relapses at a future stage, I can't provide any. I don't have any contact with people during a relapse - I am virtually housebound. Nobody has ever visited me during a relapse. I don't keep a diary. My bank statements would show that I don't go to ATMs or shops during a relapse, but I'd very nervous about giving them to the DWP.

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6 years 9 months ago #189959 by nick h.
Oops - I've just found the download about "PIP Sample Appeal Submissions". So I'll write a detailed letter. The assessor's report says "the reported restriction would be unsupported" five times. I can easily explain how the restrictions are supported.

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6 years 9 months ago #189960 by Gordon
Nick

You must explain your reasons for making the MR request, but if you want more time to set these out then provide basic reasons and tell the DWP that you will be supplying more information as soon as you can. They should allow you four weeks to do this, but sooner is better.

If your issues are variability then the first thing that you need to be aware of is that you need to be able to talk about the majority of days, this does not have to be as black and white as when you are affected and when you are not, but you will need to show some level of limitations sufficient to score points most days of the week, month or year.

Also the limitation must be in relation to the PIP activities. Not going to the ATM is unlikely to demonstrate this.

Have a look at the section in the Claim guide about "reliably", there is also a section that explains the scoring for variable conditions.

Gordon

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

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