PIP

Hi Caz

I'm sorry you find yourself in this position.

After you had your assessment did you ring the DWP and ask for a copy of the assessment report (PA4)before putting in your mandatory reconsideration? If you didn't then you need to ring and ask for it as this will tell you the reasoning behind their decision. Their decision is just an opinion and many people successfully overturn a decision at appeal. I assume no one has actually seen you walk, and I don't know which box you ticked, but they would have made a judgement from what you wrote and said. I'm struggling to understand their reasoning on you doing your own injections - but then we often are puzzled by comments from the DWP. Specific information is often ignored.

The first thing you want to do is to look at the Guide to PIP Appeals which will walk you through the entire process. Have a look at the guide first and if you have any specific questions. Also, go back to the PIP guide and see if there's anything that you might have explained better that you can improve on at appeal.

BIS

Hi Caz35,
To add to BIS' reply. Don't be afraid of a tribunal. They are fairly informal a bit like a meeting with your manager at work. If you watch tv court dramas, you will think tribunals are all about wigs and gowns and accusing fingers, and loads of people watching. Tribunals are designed for people to be able to represent themselves, and members of the public seldom attend. (I have never had anyone attend, and the Judge could exclude anyone if he felt it would hinder the proceedings. If the tribunal is via phone/video no one else would be able to attend!)
What you will need to do if you do decide to appeal is to fill out an SSCS1 form - this can be done online or via hard copy/post.
There isn't anything especially complicated about the form, it is mostly personal details, when you are available for a hearing etc. The only vaguely complicated bit is the grounds for appeal. You can put as little or as much as you like here. it is ok to say simply that you are appealing solely Mobility (assuming you are content with the Daily Living result.) Then say that DWP has failed to understand the true nature of your walking ability and should have awarded X points.

However you do have an opportunity to say more if you wish. Think about your walking ability, unfortunately you haven't stated how far you can walk, so I don't know which descriptor is correct. I will therefore advise generally.
PIP points are awarded when you can not perform an activity
safely
in a reasonable time
to an acceptable standard
repeatedly across the whole day as reasonably required
All 4 criteria must be met. (These are all explained further in the members guides.)
Pain is particularly relevant for walking ability. I like to compare it with the 'duracell battery test' . If you have seen the adverts, the duracell toy goes for miles and miles, until it finally packs up, and of course much further than it's rivals. It is easy to think that PIP walking is like the duracell battery. Wrong! It is not the bust a gut, go until I drop scenario. Firstly if you have severe discomfort (which is not the same as severe pain!) this will end you walking distance - walking with severe discomfort has to be ignored. So if you can manage say 1 mile because your car has broken down and you need to get home etc and you are in great pain it won't comprise your PIP walking ability. Therefore legally, if you can mange say 15m before the pain comes on, but grind through it, whilst you might ultimately walk that mile your PIP ability will be 15m, and that's all. (Not the duracell total walk at all!) Severe discomfort can be pain, (anywhere, not just legs etc) breathlessness, perhaps even dizziness as well.
Think about safety - falls (or more importantly stumbles - as these are only a wobble away from a fall!) If you do either this could indicate you are at risk of injury and hence are not 'safe'.
Time - can you walk the distance taking no more than twice the time an able bodied person takes. (Do you walk slower than eg a friend - maybe they have to slow down so you can keep up?) Sometimes you may need to stop for a rest. This might just be resting against a wall, or a seat if there is one. It might comprise a 10 second pause, or it might be a proper sit down for a few minutes. If the latter is the case, it is likely that when you recommence walking it is a second period of walking. A short distance with a long rest/s is very unlikely to fit within the reasonable time scale.
Acceptable standard- pain, discomfort etc - falls/stumbles all indicate not acceptable. Think also about the manner of your walking - do you have a peculiar gait etc - this could all indicate not being acceptable. Maybe you sweat terribly, or chafe, or knees lock up and have to be moved by hand - again not acceptable.
Repeatedly - whilst a series of very short walks with pauses and restarts could indicate repetition it is likely that there will be pain/severe discomfort or being out of time, being unsafe through greater risk of falls etc that indicate you can't actually repeat the walk to fit into all of the 4 criteria. However you need to show that you can't go out several times in the day. Tribunals have concluded that disabled people should not be obliged to take an easy option so DWP can say 'no points'. Think about having to wear loose easy pull on clothing as opposed to smart tailored shirt and tie for a man - which he struggles to do up. This is the principle of normality. Why can't the disabled man look smart? It isn't unreasonable, therefore he should be able to claim points for needing help with dressing.
Therefore think about walking. Ok, you may take the car or ask a friend, but it is not inconceivable that you would want to walk to the village shop for some milk in the morning, and come home, You might realise that you forgot to post the letter, or you might need to go to the bank. You could have a GP appointment later in the afternoon, and might want to pop round to a friend's house to watch a movie in the evening. None of these activities are in any way unreasonable, and all of the destinations are in easy walking distance. (The sort of distance that would usually be walked, and take 10-15 minutes maximum.) So could you manage to do these sorts of walks across the whole day. I have given 4 examples, but it could be more? Maybe you could manage the first trip, but what about the subsequent ones? I suspect from what you describe, that even if you were able to do the first trip, your disabilities would preclude you repeating walking across the whole day, maybe you could do 2 walks, but 3, 4 perhaps not. Therefore if so, you would not fall within the priniciple of normality and would fail to walk repeatedly, across the whole day as reasonably required. Even if you could do 3 out of 4 walks as suggested above, but were unable to do the fourth, then you can not walk 'repeatedly' per PIP law.
You will need to think about what stops you repeating walking - pain/fatigue/legs give way etc - and maybe if you do something one day, you might not be able to do something the next day/s.
Finally, once you have considered all of the above, you may arrive at a walking amount that you can so safely, timely, acceptably and repeatedly. It might be only 5 metres, or maybe it is 25. If there is anywhere you walk regularly eg to shop, even just down the drive - think about the length of the walk and what prevents you going further. A friend/partner can always pace out the walk to get a rough idea of distance if need be.
Remember that all PIP activities (mobility and daily living) will score points when you can't perform the activity for the majority of days, so even if you have a better day every now and again, and manage to do more this won't matter and won't mean you can't score points because there are many more days where you can't perform.
So, now you understand about walking for PIP, it may be that you can analyse how you walk and be absolutely confident of exactly how far you can walk (ie under PIP law and not the duracell walk.) It may not be a very big amount, but it doesn't matter. You can describe your walking and explain how you do/don't fall within the above criteria and majority pattern if this applies. If you have medical evidence which could from a physio/doctor etc send this in. You can refer to it and say how it confirms your poor balance or range of motion etc. Send it again/refer to it again even if sent before - DWP have clearly ignored it and you can say so! Maybe a friend can write a statement about how you walk - this could also help.
This all means instead of writing the very basic grounds of appeal I initially suggested you can write a detailed few paragraphs explaining first briefly your illness and when you were diagnosed etc and the general effect on your health. Then you can describe all the facets of your walking and use that to show which descriptor applies and how many points, and say so. (It may not be relevant to you, but if you decide that two or more descriptors apply equally, then the highest value points should be scored.)
A final piece of advice. If you can type (or write neatly) any lengthy grounds of appeal as a separate sheet. You can upload this as evidence, as with any other medical reports etc. If you try and type a several paragraphs in the provided box, when printed out it comes out with no formatting in one long script which is very difficult to read! Make sure all separate pages have name and NI Number clearly marked.
You indicate a face to face hearing (video/at court room/phone) rather than paper - paper hearings won't allow you the chance to speak and or be seen/heard. You can choose whether you have all of the face to face options or just some as you prefer.
Once you fill out the SCCS1 form - which you should do within a month of the MR decision date. (If you have good reason you can do this late, but then you might have to argue why it's late and run the risk of it being rejected.) If using the online form you get a receipt and will get updates if you leave email address etc.
The appeal will be processed by HMCTS and DWP have 1 month to prepare and send out the appeal papers (bundle) - this is copies of all claim forms, decisions, MR SSCS1 form etc - the tribunal will see this. You will get a copy and if you wish you can comment further if there is anything more you wish to say.
It is entirely possible that if you write a full grounds of appeal, and give examples etc as I have described above - then DWP may concede and award more points. If not, then you can attend at the tribunal, and it is very likely that they would find in your favour (appeal statistics do show that most appeals are upheld.)
I have to warn you that a tribunal may wish to consider the daily Living award and review it. On a few occasions tribunals have decided that this was incorrectly awarded and reduce/remove it. This is a very rare event, but if they are minded to do this a full warning must be given, and you could then withdraw the appeal and not pursue the mobility award. The daily living award would then remain. Hence there is a very small risk attached to appealing, but the potential gain is considerable and therefore it is worth taking the risk.
I do hope that you will consider appealing. I appreciate it may sound daunting, and it is unpleasant that you have to do this to get the benefit amount that truly reflects your disabilities. However, unfortunately this seems to be the route that DWP takes. I am sure that I speak for everyone on B&W that they will be keen to follow your tribunal journey and will be pleased to offer more advice and support should this be necessary.
I wish you very good luck.
I hope this helps.
LL26