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TOPIC: Appeal with recurring conditions - Any advice?

Appeal with recurring conditions - Any advice? 8 months 1 week ago #203109

Hi there,

I've just had my tribunal date for end of Jan 2018. I'm in the process of going from DLA to PIP. I suffer from 3 fluctuating and recurring conditions and have done since I was 9yrs old (I'm 32 now). The decision we received was grossly inaccurate to the point of bordering on fraudulent statements.

I've made my subject access request and am in the process of going through a LOT of paperwork and have already noticed that statements the HA made have been totally disregarded by the decision maker or even completely rewords. One such example is the fact that although I have chronic pain, due to multiple medications and their interactions, cannot rely on NSAIDs or opioids. This was picked up on by the HA but the DM just made statements of "X is not prescribed pain medication".

I've also contended a lot of inaccurate statements in my tribunal appeal paperwork such as not being on any MH medication (I'm on anti-depressants for anxiety).

However, my biggest concern is that if I'm having a "good day", that this will ultimately reflect badly on me as I cannot quantify when my conditions deteriorate nor for how long. I've read up in the Equality Act (2010) guidance about how the substantial effects are "treated as continuing if it is likely to recur" - surely this is an argument that can be presented given that the EA is also what the PIP assessment derives it's "every day" activities from.

Currently I'm keeping a diary. One of my conditions is skin related so I'm also taking regular photos. Because I've had my problems for so long, I tend to just get on and deal with a lot of problems. I suspect that this positive attitude also worked against me during my initial health assessment.

I also have friends willing to write statements for me about how they've seen me and the impact it had.

Currently my main argument with the decision are the following points:

- The gross misrepresentation of information presented.
- The fact that they are using specific criteria for assessment that the government guidelines actually presents as examples of how you could receive assistance.
- The fact that the activity criteria are far too specific and only offer either a positive or negative answer when there are conditions which do not fall under these criteria at all.
- The fact the PIP exists to assist with additional costs. Just because my costs do not revolve around needing to pay for outside help (such as a carer) does not mean that my additional costs do not exist
- The fact that during the assessment the HA point blank refused to look at my condition on what was a "good day" to see that even on a "good day", my condition still sucked.

Does anyone who has had experience with fluctuating/recurring conditions and appealing have any advice? Am I taking too robust an approach? In the decision I was penalised for being knowledgeable about my conditions, well spoken and engaging with the HA. Right now, I feel that because I have a positive outlook, understand my conditions and have learned to just get on with it, not to mention because they're not "visible" to the average onlooker, that I'm being treated like a fraud.

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Appeal with recurring conditions - Any advice? 8 months 1 week ago #203135

L

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

Welcome to Benefits and Work

In case you are not aware, your real name appears to be showing in the forum, if you want to change this then follow the instructions in the following FAQ

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A couple of immediate points from your post.

I'm concerned that you refer to documents resulting from a Subject Access Request, it is essential that the panel have access to any information that you refer to in your appeal or they cannot consider it on the day of the hearing and could adjourn it for the information to be provided.

I would have expect all of the information that you would want to make use of to have been in the bundle of information that you would have received from the DWP. I would encourage you to go back through the information and to use the documents supplied by the DWP, there will a Tribunal Service page number, hand written in the top right corner of each page, use this as your reference point.

I would not push the Equalities Act in your submission, PIP already has legal definitions for variable conditions and Case Law that further define them, they will be used in preference to any argument that you might make under the EA.

As to your arguments, I'm afraid there is only one that counts, that you have shown that you meet the criteria for an award. It's important for you to deal with the issues in the assessment report but doing so will not in itself result in an award, so this should be a secondary process.

The PIP activities are legally defined, arguments that they do not fit your conditions will not work, you can only score points by explaining the difficulties you have in "reliably" completing the PIP activities "on the majority of days"

In a similar vein, issues of what you might spend your PIP payments on are not relevant.

Our PIP Claim guide explains the issues of reliability and fluctuating conditions in more detail.

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

If you have further questions the please reply to this post and we will do our best to help.

Gordon
The following user(s) said Thank You: Recluso

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

Appeal with recurring conditions - Any advice? 8 months 1 week ago #203144

Hi Gordan, thanks for your reply.

I've changed the name issue - thanks for pointing that out!

I've been having a look around but was having difficulty finding anything about recurring issues. Apologies if I missed anything obvious. I'll continue to look around as well.

Your insight is already appreciated. I'm not going to lie, I'm furious at the fact that I feel like I've been made out as though I've made up how severe my issues can be when I know it's not normal that I've had months at a time where I can barely walk but feel penalised for the fact that on a good day, and naturally the day of my assessment, I was having much more ease moving around and that this isn't normal, but valued as the rarity it is but spent waiting for the next time in dread of when it'll not be like that.

I know it's probably naive, but it feels as though my having been on DLA for the past several years means nothing at all and that the historic guidance and evidence of my doctors regarding my conditions is now being thrown out of the window.

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Appeal with recurring conditions - Any advice? 8 months 6 days ago #203162

Recluso

You need to review the following sections in the PIP Claim guide.

‘Reliably’- the most important PIP word - page 16
Scoring points when your condition varies - page 20

Gordon

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