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advice with pip claim please

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5 years 7 months ago #215770 by badoop
advice with pip claim please was created by badoop
Hello Gordon
My husband recently had to do the dla to pip changeover, we were very lucky in so much as he got a paper based assessment because both gp and psychiatrist said he would be unable to do a f2f.
the forms and both letters were sent off mid june time and that was all we heard until I rang them today to see what if any progress had been made on the claim, we learnt that my husband has been given standard care only. Previously on dla high care and low mobility.

we live in northern Ireland so even though we were only told the decision on the phone and have to wait on the letter in the post I have asked also for the assessment report to try and see where my husband got awarded points.

We feel that he should have got enhanced care but again do not know what his points were and the person on the phone would not tell us this or how long the award was for and said we would have to wait on the actual decision letter.


Could you please tell me what is the next step for us if on reading the report we feel they did not give points where we feel he should have got some. Is it possible that standard care is the best you can hope for under pip?


Thanks for you time and advice gordon

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5 years 7 months ago #215784 by Gordon
Replied by Gordon on topic advice with pip claim please
badoop

The Decision Letter will explain what points have been awarded and why others have not.

If you reasonably believe that he should have scored 12 points or more for the Daily Living component then you should consider challenging the Decision.

The first stage to doing this 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
The following user(s) said Thank You: badoop

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5 years 7 months ago #215868 by badoop
Replied by badoop on topic advice with pip claim please
Hello Gordon
from my previous post we have got the decision letter today. my husband has got 11 points for care and 4 for mobility they state it for ongoing period this is for severe mental health problems.

Now we are faced with the decision of a MR or leave it alone, I feel he should try and see if he can get the extra point, but do we risk loss of ongoing award.

I have spoken to his Gp today who thought the award length was great but felt he should of got enhanced care, our GP said for me to leave the decision letter in and he would look at it and give us another letter highlighting where he felt my husband should have got more points, we do have a wonderful GP and he will always do his best for us.

husband got
2 for prep food
1 for managing treatments
2 washing and bathing
2 dressing and undressing
2 mixing with other people
2 making budgeting decisions

4 planning and following journey

I would be grateful for your take on this Gordon if you would be so kind

thanks

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5 years 7 months ago #215886 by Gordon
Replied by Gordon on topic advice with pip claim please
badoop

The odd point is usually a bigger problem than it appears as it usually means that the claimant actually needs to score two extra points unless you can show that he is unable to get in and out of an unadapted bath or shower.

The Daily Living activities do not just increase in severity as the points go up, additional criteria is also introduced, so you are going to have to go back through the Descriptors he scored for and those that he didn't but may have expected to see if you can show that he meets that criteria

Remember that reliably and on the majority of days still apply.

I think it quite unlikely that the On-Going award will be reviewed, we very rarely see it changed when the length of the award is challenged and I think the same arguments will be valid for just challenging the points.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
The following user(s) said Thank You: badoop

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5 years 7 months ago #216131 by badoop
Replied by badoop on topic advice with pip claim please
Hi Gordon,

as per previous post the points below were all for prompting according to the assessors report.
husband got
2 for prep food
1 for managing treatments
2 washing and bathing
2 dressing and undressing
2 mixing with other people
2 making budgeting decisions

4 for undertaking a journey

after much thought and speaking to our Gp we are going to ask for a Mandatory reconsideration as our GP said that as far as food prep, mixing with others are concerned he feels that my husband need assistance as he can not do these things with prompting alone and needs someone to be with him.

Gp also thinks that undertaking a journey is also an issue as my husband will not leave the house at all unless he is accompanied with another person at all times. Gp has said he is going to write another letter stating that husband needs more than prompting.

another question if i may, on the decision letter it states for mobility

At this time we can not award you mobility, is this anything to do with the recent news about making journeys and mental health?. Also do we just send in a MR by post with Gp letter or do we need to phone aswell.

Again many thanks for your help

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5 years 7 months ago #216140 by Gordon
Replied by Gordon on topic advice with pip claim please
[quote="badoop" post=216131another question if i may, on the decision letter it states for mobility

At this time we can not award you mobility, is this anything to do with the recent news about making journeys and mental health?. Also do we just send in a MR by post with Gp letter or do we need to phone aswell.

Again many thanks for your help[/quote]

I don't think so, the DWP updated their guidance on Going Out at the end of June which appears to be before this Decision was made, plus the four points for Undertaking a Journey argues against him meeting the criteria for Following a Journey and the higher points.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
The following user(s) said Thank You: badoop

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