Mandatory Reconsideration Letter

Thank you Gordon, I have posted the main part of my letter and one of my arguments, sorry it's a bit long, but it wouldn't make sense otherwise.

Dear Sir or Madam
I am asking for a Mandatory Reconsideration, regarding the decision of 20th October 2017, that states I am not entitled to the care rate of PIP, something that I have been getting for years, and in that time my condition has not improved or changed, and now I actually need more help than ever I did. This time I have not been awarded care rate, and I consider this to be incorrect for the following reasons.

I have Eisenmengers (irreversible Pulmonary Vascular Disease) with Secondary Pulmonary Hypertension.

And I do not consider that sufficient weight was given to how my heart and lung condition impacts me on a daily basis, or the effects it has on my ability to look after myself adequately. I also feel what I stated both verbally in my face to face assessment and in written form with the evidence I sent in was not listened to as the decision maker report I got back is saying things that aren’t correct. I am so disappointed that the DM has read through all the evidence I sent and decided that despite having one of the most serious heart and lung complaints there is, thinks I am fit enough to look after myself, and thinks I can wash myself, cook for myself and dress/undress myself to an acceptable standard with a aid, when I clearly stated a number of times that I need another family member to help do these things for me as these are the things I struggle most with.

The decision maker has said in their statement that my needs vary from day to day, and the decision is based on the help I need most days. This is incorrect as I need some sort of help everyday, whether that be getting my meals made for me, getting help to wash or to dress/undress there is always something on a daily basis. I wrote in my first statement about the side effects I have with my condition, the coughing up blood, palpitations, headaches, breathlessness, chest pain, extreme fatigue, lack of energy, cyanosis, are things I suffer with everyday. How do you think anyone that lives with those symptoms every day is fit to look after themselves properly on their own, without any help from another person?




After reading the assessment report the assessor has wrongly stated that I only seem to need help every 3 months. As I tried to explain to her when I take haemoptysis (coughing up blood) it can last up to 3 months or more at the time. But it can vary, it could easily last 4 or 5 months at the time. Go away for 2 weeks and come back again for another 2 or 3 months. The assessor seems to think I only need help when I am coughing up blood, and while it is the side effect that impacts me the most. I still have to contend with severe chest pain, extreme fatigue, breathlessness, low energy, palpitations, pressure headaches, cyanosis, and these are symptoms I have every day of the year. They also seem to think I only have “bad days” when I am coughing up blood, again not true, the list of other symptoms that come with having this condition means most days of the year are bad days for me.

But I do also feel that the impact and seriousness especially of the bleeding in my lungs as well as the rest of my symptoms has not been understood in both the assessor's report and the DM’s letter. And also the impact it might have on me if I was to try and do these things myself without the proper help. So I will try again and explain how awful these make me feel.

The majority of days I will wake up with a with some or most of the side effects I have listed above. The minute I get up the first thing I will feel is chest pain, and even the simple of act of going to the loo will make me breathless. Every day I will have at least 3 palpitations, these come out of the blue and some of them can be so bad they have on many an occasion left me on the verge of passing out. I will always have a pressure headache that will get worst when I get up, and start moving, even if this is only going to brush my teeth, it takes me doing something so little and it leaves me feeling all these things. These are things I have to contend with everyday, there are no “better days” these side effects are part of the condition and there is no way to stop them coming. When I have bleeding in the lungs, I will have a wheeze in my chest, and I will have to cough at once, normally I will just do this in bed, and my Mum will get me a basin to cough into. Like I have stated the bleeding in the lungs can last for months on end, I would say I have it 85% of the year. And even when I don’t have it, it takes weeks and months to get over it, before it just comes again. It is a awful side effect as I could easily cough up a glass of blood each time, this would be everyday for months on end. So I am losing a lot of blood at the time which leaves me in an even worst state. Everything hurts when I have bleeding in the lungs, especially my chest, head, and my actual lungs. This then impacts my breathing and I don’t get enough air in, making me even more breathless. I have passed out a number of times over the years as I can barely get up out of bed when I cough so much blood and any exertion at all will leave me in this state.

Preparing food.

For this the decision I got from the DM was,

Needs to use an aid or appliance to be able to either prepare or cook a simple meal. 2 points
I would like to dispute this, and feel I should have got the score below:
Needs supervision or assistance to either prepare or cook a simple meal. 4 points.

This is because as I already stated I am not fit to make a simple meal all by myself. The DM has claimed I can make a simple meal using an aid, on the majority of days. This is not true, because of my condition and the side effects it has I need this help every day. To make a simple meal still involves a lot of different aspects, as you are still using fresh ingredients. You have to first get the ingredients, stoop to get saucepans out of the cupboard, reach up to get a plate and glass, and also get the cutlery. Then you have stand at the sink and wash the veg, peel it then chop it, get whatever meat you are using, prepare it, depending on the meal you may have to lift a heavy kettle of boiling water over to the pan etc so many things, yet the DM claimed that just because I on the rare occasion have helped my Mum with the Sunday dinner by sitting on a chair to chop a few veg I can now do all of the things above. I will go through each point in detail and explain why I can’t. Stooping to get a saucepan would leave me lightheaded and breathless, I would be unable to reach up to the cupboard to get a plate or a glass as this hurts my chest and again just doing this makes me feel weak, lightheaded and feeling strong discomfort in my chest. Then there is the effort of starting in to chop up whatever the ingredients are, and even if I did this sitting on a chair, I would still be feeling extreme fatigue while doing it, and would have to rest afterwards. After that pans or dishes would have to go into the oven, as we have a under the counter oven, that would mean more beading over for me, not only to put the dish in but also check on it, and bring it out. If the meal was something you put on the hob, this would mean continuously checking on it, stirring it, which would mean long periods of standing. And again due to extreme fatigue this would be impossible for me to do. As you prepare food everyday, usually 3 times a day this is something I need help with everyday, so unless I get the help of my Mum I would be unable to cook a simple meal by myself to an acceptable standard for the majority of days even with the use of an aid.

Will welcome any feedback.

Please don't apologize Gordon, this sort of advice is exactly what I need. Although to be fair my assessment was done at home. And also I did think I had made it clear about the list of side effects I have every day I have a letter from my specialist and my GP that backs this up. But of course like you say it would be a good idea to reference this.

Your advice about the aids is very helpful, I honestly didn't know there was so many. I am going to have to amend this but I do have some time left yet.

I am going to the CAB tomorrow as well to help with this. Thanks Gordon, this is such a help to me.

So I got my MR decision back today, and I'm delighted to say I won, and got the points I needed, so just wanted to report the good news, thanks all