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Challenging a PIP decision
- PAUL
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5 years 11 months ago #212046 by PAUL
Challenging a PIP decision was created by PAUL
Greetings Ladies and Gentlemen,
I've been perusing this site for a while and it seems there are some very knowledgeable people on these forums regarding subjects that I have a few questions about, so I've decided to join up and see if I can receive any helpful advice. I'll attempt to explain my medical situation in a way that hopefully won't bore anyone to death.
Back when I was 16 I was subject to a rather terrifying experience in a storm that happened to be pounding Britain at the time. I managed to fight through the storm and make my way home but found that the next day I could not leave my house due to a heightened feeling of anxiety. These events occured back in 1990 and for the last 28 years I have been basically unable to travel more than 200 metres from my house. Any attempt to travel further than that can result in a full-on hysterical panic and an overwhelming and compulsive need to return to my house. It has not been the most enjoyable situation to be honest but I try to get by.
A few months ago I was contacted by the Department of Work and Pensions and informed that my Disability Living Allowance was ending, and was then invited to make a claim for Personal Independence Payment, which I promptly did. I had my assessment at home and told the assessor that while I am physically capable of moving around and performing activities that a physically disabled person would not be capable of doing, I am nonetheless disabled as I cannot travel anywhere, and continually reiterated that my limitations were mental and not physical.
A few weeks later I received my decision, which was a rather lacklustre 0 points and was told that I do not qualify for either the higher or lower components of PIP. I decided to ask for a mandatory reconsideration notice and a few weeks later received the same nil points with no change in the decision.
I am currently receiving ESA from the DWP, and realise I probably sound greedy in trying to obtain the PIP as well, but I just want to be able to support myself. I obviously still live at home with my mother, and while I pay her a certain amount of keep every week she pays most of the bills, and unfortunately, as is the case with life, she's not getting any younger, and I fear for how I will support myself after she is gone.
Back in the mid 1990's a doctor was sent to my home to assess me for DLA. He concluded that I was entitled to the lower component, which was around £20 a week, which was paid in monthly. Considering it was the DWP that invited me to make the claim for PIP I was under the impression that it would include similar conditions of disablement to those covered by DLA, but my decision maker was emphatic that it does not. In her own words: "You mention your previous DLA award. PIP is a different benefit and has different criteria to DLA." It seems a bit nonsensical that they would replace a benefit that took consideration of my condition with one that does not.
I actually concur with the decision and the score of the daily living part of PIP as I honestly have no problems with my physical mobility and would not contest it, but cannot help but feel I have suffered a disservice with the mobilty part.
I have no idea how they awarded me 0 points for the mobility activities. "You can plan and follow a route of a journey unaided." I haven't made a journey in 28 years!
I specifically told the assessor that 200 metres is probably the maximum distance of my safe zone. My result was, "You can stand and then move MORE than 200 metres either aided or unaided". I feel this is fallacious and totally misrepresentative of my position.
To get down to the questions: Is it worth trying to appeal to a tribunal? I understand there are two methods of doing this, paper and oral, with the oral having a higher chance of a successful outcome . I would like to try the latter, but am not sure whether they would accommodate my inability to get to the place of the tribunal. Can I explain the circumstances to the tribunal in the SSCS1 form?
To help bolster my case I can contact my GP for a report but am not sure whether I would be required to get a medical report directly from my GP to include with the SSCS1 form, or would the tribunal contact my GP directly?
Lastly: Is it within your experience that if a tribunal outcome was successful or not whether the DWP would retaliate by cancelling my ESA?
Any helpful advice on these issues would be greatly appreciated.
My sincere apologies for straining your eyesight with my copious paragraphs.
Kind regards,
Paul
I've been perusing this site for a while and it seems there are some very knowledgeable people on these forums regarding subjects that I have a few questions about, so I've decided to join up and see if I can receive any helpful advice. I'll attempt to explain my medical situation in a way that hopefully won't bore anyone to death.
Back when I was 16 I was subject to a rather terrifying experience in a storm that happened to be pounding Britain at the time. I managed to fight through the storm and make my way home but found that the next day I could not leave my house due to a heightened feeling of anxiety. These events occured back in 1990 and for the last 28 years I have been basically unable to travel more than 200 metres from my house. Any attempt to travel further than that can result in a full-on hysterical panic and an overwhelming and compulsive need to return to my house. It has not been the most enjoyable situation to be honest but I try to get by.
A few months ago I was contacted by the Department of Work and Pensions and informed that my Disability Living Allowance was ending, and was then invited to make a claim for Personal Independence Payment, which I promptly did. I had my assessment at home and told the assessor that while I am physically capable of moving around and performing activities that a physically disabled person would not be capable of doing, I am nonetheless disabled as I cannot travel anywhere, and continually reiterated that my limitations were mental and not physical.
A few weeks later I received my decision, which was a rather lacklustre 0 points and was told that I do not qualify for either the higher or lower components of PIP. I decided to ask for a mandatory reconsideration notice and a few weeks later received the same nil points with no change in the decision.
I am currently receiving ESA from the DWP, and realise I probably sound greedy in trying to obtain the PIP as well, but I just want to be able to support myself. I obviously still live at home with my mother, and while I pay her a certain amount of keep every week she pays most of the bills, and unfortunately, as is the case with life, she's not getting any younger, and I fear for how I will support myself after she is gone.
Back in the mid 1990's a doctor was sent to my home to assess me for DLA. He concluded that I was entitled to the lower component, which was around £20 a week, which was paid in monthly. Considering it was the DWP that invited me to make the claim for PIP I was under the impression that it would include similar conditions of disablement to those covered by DLA, but my decision maker was emphatic that it does not. In her own words: "You mention your previous DLA award. PIP is a different benefit and has different criteria to DLA." It seems a bit nonsensical that they would replace a benefit that took consideration of my condition with one that does not.
I actually concur with the decision and the score of the daily living part of PIP as I honestly have no problems with my physical mobility and would not contest it, but cannot help but feel I have suffered a disservice with the mobilty part.
I have no idea how they awarded me 0 points for the mobility activities. "You can plan and follow a route of a journey unaided." I haven't made a journey in 28 years!
I specifically told the assessor that 200 metres is probably the maximum distance of my safe zone. My result was, "You can stand and then move MORE than 200 metres either aided or unaided". I feel this is fallacious and totally misrepresentative of my position.
To get down to the questions: Is it worth trying to appeal to a tribunal? I understand there are two methods of doing this, paper and oral, with the oral having a higher chance of a successful outcome . I would like to try the latter, but am not sure whether they would accommodate my inability to get to the place of the tribunal. Can I explain the circumstances to the tribunal in the SSCS1 form?
To help bolster my case I can contact my GP for a report but am not sure whether I would be required to get a medical report directly from my GP to include with the SSCS1 form, or would the tribunal contact my GP directly?
Lastly: Is it within your experience that if a tribunal outcome was successful or not whether the DWP would retaliate by cancelling my ESA?
Any helpful advice on these issues would be greatly appreciated.
My sincere apologies for straining your eyesight with my copious paragraphs.
Kind regards,
Paul
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- Gordon
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5 years 11 months ago #212052 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic Challenging a PIP decision
Paul
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
PIP was deliberately engineered to be a more difficult benefit to award than DLA, although it deals with many of the same areas as DLA, the criteria is very different and as a result many DLA claimants will quite legitimately receive a reduced award or even no award at all.
Also, please be aware that the only view that I have of you problems is what you post on the forum, you may not have included important information or the information may be coloured by your understanding of PIP, which may not be correct.
The Going Out activity looks at three things.
Planning a route - this is primarily a cognitive or sensory (e.g. blindness) activity. You are being asked about the problems you would have with working out how to get from one place to another, you do not need to be able to follow the route that you are planning.
Undertaking a Journey - this is do with mental health issues such as agoraphobia and social anxiety and is concerned with you leaving the house to go somewhere, they will be interested in the things that stop you doing this. You need to show that you would suffer "overwhelming psychological distress" to meet the criteria.
Following a route - This activity about the problems you would have navigating a route. So are there problems cognitive, sensory or mental health issues that would prevent you from doing this? This is different from undertaking a journey, in fact if you cannot undertake a journey then you will struggle to score points for following one.
You mention no problems with planning a route so I will park this for the moment.
There appears to be some argument that you might need prompting to undertake a jorney, however, your post suggests that you live alone and can leave the house without intervention, so you would need to provide more information to support a case for this. However, the relevant Descriptor only scores four points and is not sufficient for an award.
There is a higher Descriptor for being unable to undertake a journey, however, the critiera for this is that the claimant cannot undertake any journey and you say that you can go out, albeit on a limited basis. Can you show that you cannot go out on the majority of days?
The second set of criteria are to do with following a route, you do not go into detail as to what limits the distance that you can go from your house but you can you describe these problems in terms that show you would not be able to navigate a route due to your reaction to being outside?
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.
I will warn you that it is unlikely that an MR will revise the Decision and you may have to go on to appeal.
Our PIP Claim guide explains the PIP criteria in more detail and is available on the above link.
Gordon
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
PIP was deliberately engineered to be a more difficult benefit to award than DLA, although it deals with many of the same areas as DLA, the criteria is very different and as a result many DLA claimants will quite legitimately receive a reduced award or even no award at all.
Also, please be aware that the only view that I have of you problems is what you post on the forum, you may not have included important information or the information may be coloured by your understanding of PIP, which may not be correct.
The Going Out activity looks at three things.
Planning a route - this is primarily a cognitive or sensory (e.g. blindness) activity. You are being asked about the problems you would have with working out how to get from one place to another, you do not need to be able to follow the route that you are planning.
Undertaking a Journey - this is do with mental health issues such as agoraphobia and social anxiety and is concerned with you leaving the house to go somewhere, they will be interested in the things that stop you doing this. You need to show that you would suffer "overwhelming psychological distress" to meet the criteria.
Following a route - This activity about the problems you would have navigating a route. So are there problems cognitive, sensory or mental health issues that would prevent you from doing this? This is different from undertaking a journey, in fact if you cannot undertake a journey then you will struggle to score points for following one.
You mention no problems with planning a route so I will park this for the moment.
There appears to be some argument that you might need prompting to undertake a jorney, however, your post suggests that you live alone and can leave the house without intervention, so you would need to provide more information to support a case for this. However, the relevant Descriptor only scores four points and is not sufficient for an award.
There is a higher Descriptor for being unable to undertake a journey, however, the critiera for this is that the claimant cannot undertake any journey and you say that you can go out, albeit on a limited basis. Can you show that you cannot go out on the majority of days?
The second set of criteria are to do with following a route, you do not go into detail as to what limits the distance that you can go from your house but you can you describe these problems in terms that show you would not be able to navigate a route due to your reaction to being outside?
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.
I will warn you that it is unlikely that an MR will revise the Decision and you may have to go on to appeal.
Our PIP Claim guide explains the PIP criteria in more detail and is available on the above link.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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- PAUL
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5 years 11 months ago #212063 by PAUL
Replied by PAUL on topic Challenging a PIP decision
Hello Gordon,
The MR has already been unsuccessful, the only course of action is a tribunal now. I'm reading your reply regarding the Going Out Activity and whether a tribunal would be successful based on the points you mention.
Regarding Planning a route. I admittedly would have no problem planning a route as it would be the travelling of said route that would pose problems.
Undertaking a journey is definitely a problem, as I suffer dizziness, palpitations,, hyperventilation, complete loss of cohesive thought processes etc. Due to these conditions of fight or flight that are prompted by trying to go out, I tend to avoid the situation entirely. Even the mere mention of trying to get somewhere is sufficient to cause anxiety. How I can prove this to a tribunal I have no idea, other than someone wiring me up to a biofeedback monitor and recording the results on my sympathetic nervous system during a journey, or receiving a letter from the psychiatric hospital that I assume still has my reports from the 90's.
Following a route, As you said, if I can't undertake a journey then following a route would be a difficult one to answer.
I have a radius that I can travel to, and there are two places within that radius that I can travel to. A restaurant. and the nearby petrol station and they are each within 1 minutes walk. I rarely go out though, as there is no impetus to when there isn't anywhere within my radius comfort zone. I can't get to the town centre, the cinema, the local hospital. A month can pass where I don't leave the house at all.
I've been looking at the phone numbers in your links, and am wondering if I should contact Scope, or possibly the CAB.
The MR has already been unsuccessful, the only course of action is a tribunal now. I'm reading your reply regarding the Going Out Activity and whether a tribunal would be successful based on the points you mention.
Regarding Planning a route. I admittedly would have no problem planning a route as it would be the travelling of said route that would pose problems.
Undertaking a journey is definitely a problem, as I suffer dizziness, palpitations,, hyperventilation, complete loss of cohesive thought processes etc. Due to these conditions of fight or flight that are prompted by trying to go out, I tend to avoid the situation entirely. Even the mere mention of trying to get somewhere is sufficient to cause anxiety. How I can prove this to a tribunal I have no idea, other than someone wiring me up to a biofeedback monitor and recording the results on my sympathetic nervous system during a journey, or receiving a letter from the psychiatric hospital that I assume still has my reports from the 90's.
Following a route, As you said, if I can't undertake a journey then following a route would be a difficult one to answer.
I have a radius that I can travel to, and there are two places within that radius that I can travel to. A restaurant. and the nearby petrol station and they are each within 1 minutes walk. I rarely go out though, as there is no impetus to when there isn't anywhere within my radius comfort zone. I can't get to the town centre, the cinema, the local hospital. A month can pass where I don't leave the house at all.
I've been looking at the phone numbers in your links, and am wondering if I should contact Scope, or possibly the CAB.
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- Gordon
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5 years 11 months ago #212072 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic Challenging a PIP decision
Paul
If you can get trained advice then I would definitely advise it.
You need to pick your battle for the Going Out activity, the more you argue to score for both tasks the less likely you are to score at all.
Remember both options require you the be able to complete the tasks reliably.
Gordon
If you can get trained advice then I would definitely advise it.
You need to pick your battle for the Going Out activity, the more you argue to score for both tasks the less likely you are to score at all.
Remember both options require you the be able to complete the tasks reliably.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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