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Template for PIP Mandatory Reconsideration letter
- Mackemlass
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6 years 10 months ago #190967 by Mackemlass
Template for PIP Mandatory Reconsideration letter was created by Mackemlass
Is there a template for this? I've looked and can't find one. Perhaps I'm looking in the wrong place.
My daughter has been awarded 7 points for daily living and we believe she should get 2 more for washing and bathing. She has uncontrolled epilepsy (between 8 and 20 seizures every day) with no warning. It is so unsafe for her to use a bath that her Occupational Therapist had her bath removed and a level-access wet room shower with fold-down shower seat installed. She is still at risk of injuring herself when showering - falling from the seat and crashing into tiled surfaces - so she does not shower unless I am in the house with her, keeping in constant contact with her via a two-way baby monitor. Her doctor has provided a letter in which he has stated that she has over 200 seizures a month and cannot bathe unsupervised. The Assessor is aware of all of this.
The Assessor has awarded her 0 points for washing and bathing. In his justification he states 'Although she has significant absences and convulsions she can take showers instead of bath, thus she can manage this task reliably.' In the functional history he states 'Her mum just monitors her with the baby monitor so she does not need to be in the bath or at the door.'
We would argue that she needs to use an adapted shower; that she needs to use aids (shower seat and baby monitor); and that she requires supervision (whether the Assessor believes the use of a baby monitor is adequate or not).
I'm starting to doubt myself Have I got this all wrong? Any assistance or guidance would be much appreciated.
My daughter has been awarded 7 points for daily living and we believe she should get 2 more for washing and bathing. She has uncontrolled epilepsy (between 8 and 20 seizures every day) with no warning. It is so unsafe for her to use a bath that her Occupational Therapist had her bath removed and a level-access wet room shower with fold-down shower seat installed. She is still at risk of injuring herself when showering - falling from the seat and crashing into tiled surfaces - so she does not shower unless I am in the house with her, keeping in constant contact with her via a two-way baby monitor. Her doctor has provided a letter in which he has stated that she has over 200 seizures a month and cannot bathe unsupervised. The Assessor is aware of all of this.
The Assessor has awarded her 0 points for washing and bathing. In his justification he states 'Although she has significant absences and convulsions she can take showers instead of bath, thus she can manage this task reliably.' In the functional history he states 'Her mum just monitors her with the baby monitor so she does not need to be in the bath or at the door.'
We would argue that she needs to use an adapted shower; that she needs to use aids (shower seat and baby monitor); and that she requires supervision (whether the Assessor believes the use of a baby monitor is adequate or not).
I'm starting to doubt myself Have I got this all wrong? Any assistance or guidance would be much appreciated.
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- Gordon
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6 years 10 months ago #191016 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic Template for PIP Mandatory Reconsideration letter
Mackemlass
There's a template MR letter in the Appeal Submissions document in the PIP area.
The DM may be using a very specific interpretation of Supervision;
“Supervision” means the continuous presence of another person for the purpose of ensuring your safety."
and assuming that "continuous presence" means that another person has to be with the claimant. There are no further definitions for this and I not aware of any Case Law that deals with the word "presence" and a quick look at the dictionary does not help.
I think that you need to argue that even using the baby monitor that someone is still present and in particular that they are within a reasonable distance to take effective action should your daughter have a seizure while taking a shower.
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
There's a template MR letter in the Appeal Submissions document in the PIP area.
The DM may be using a very specific interpretation of Supervision;
“Supervision” means the continuous presence of another person for the purpose of ensuring your safety."
and assuming that "continuous presence" means that another person has to be with the claimant. There are no further definitions for this and I not aware of any Case Law that deals with the word "presence" and a quick look at the dictionary does not help.
I think that you need to argue that even using the baby monitor that someone is still present and in particular that they are within a reasonable distance to take effective action should your daughter have a seizure while taking a shower.
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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