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PIP appeal hearing

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2 years 4 months ago #273144 by M
PIP appeal hearing was created by M
Hello,

I had a few questions please can you help me.

1. For the PIP appeal hearing, is it better to request for an oral hearing as opposed to an in person one? The thought of going to the hearing and stress of it makes me feel unwell, but at the end of the day I would prefer to choose the option which gives me the best, and most fair possible outcome irrespective of how it makes me feel.

2. Based on my PIP assessment (I had not submitted a written statement or any medical evidence as far as I recall, not sure if they even had details about who my GP was - it was a year ago, I just started working on the form online, don't even know how to access it anymore)- based on the assesment alone - my PIP claim was rejected.
My assesment was recorded and they have given me the CD for it, except for I have never listened to it. But their reasons for rejecting me are silly, and I am sure I didn't say some of the things they said but I have not been able to personally re listen back to it.. writing the personal statement about my issues was hard enough.

Then it, went to the mandatory reconsideration stage - there was a bunch of issues whereby they said they would send me the report about why I was rejected but they never sent it me on time. Anyways due to continually struggling with my mental health, I was unable to finish writing my statement. My brain had to finish writing the statement before it could move to the next step of sorting all the medical evidence out.

I missed the deadline for the mandatory reconsideration, it was the 30th of June 2022, but that was the day they also made the decision and said it was going to have to be appealed via HM tribunal if I wanted to pursue it further.

I did the necessary HMRC tribunal stuff online, they sent me a text/online they told me that DWP had to respond to my appeal by the 17th August 2022. Then, as I was still struggling with writing my statement - I called DWP around the 15th August 2022, they said that they are running behind so I'd hear back from them within 3-5 weeks, and I had about 1 week extra to submit everything (as I told them I had never ever submitted anything).

At the time of contacting DWP, I didn't really realise or understand the process- they will consider my whole application one last time and if they still do not award me PIP then it will go to the courts. The person at DWP explained to me how/what medical evidence they need etc. I literally have reports from the educational psychologist when diagnosed with X stating for example, I have issues with preparing basic meals. Not sure how or if that report is good enough for PIP.

Anyways, I called DWP again a day or 2 ago to ask what the timeline of my application was and if they had looked at my case yet, they said they had not but they would write a note on the system that I was still planning to send in more evidence. I asked them to call me back and said I would aim to sort it within 1-2 days, which they said was fine. They said they would call me and also send me a text on the day they would be looking at my application - as I explained I would like to know. I also asked them if they could bring my review earlier because the money would help me access the services I need as the NHS can't really help me much more and I am stuck with suicidal ideation etc. They said they would try. They said the final assessor would call me if they needed to clarify anything or had any questions with me prior to making the final decision aka award or for it to go to the courts.

I have now finally submitted my statement, it is literally 70 pages long for all of the 13 activities- it took me 1 whole year to write, it was that difficult. I also have finally found all the medical evidence and broken down the relevant bits of evidence into screenshots so they can see the relevant medical evidence for each activity. My follow up questions I guess are:
1. Today they will call me again, is it stupid or silly of me to ask them to keep me on the phone or to ask me about each question or activity so we can work together to make a fair decision and I can direct them to the medical evidence (although there's a 50 page powerpoint PDF which has activity 1 (then a screenshot showing the relevant part of the ADHD diagnostic report for example).
2. When I spoke to them on the phone asking them to call me I also again explained why it's been so hard for me to write the statement and sort all the evidence because I have been struggling with suicidal ideation. I asked them how they would make the decision now prior to it going to court and they said they would use all the evidence that was submitted for the HMRC tribunal hearing to make their decision. So, I asked them why they had never requested a GP report? They said it would take them a long time, and I said yeah now it is definitely too late for a GP report to come back in time but you won't have it to make an decision based on, and if my assessor back in March decided I was well enough and did not medically deserve PIP because I was doing a 2nd degree at university, why didn't she request a GP report back then?? The person on the phone said he would request a GP report now.
a. do I wait for the GP report? or tell them to just cancel the GP report?
b. does anyone know how long they actually take to make the decision? the person on the phone said that they work on each assigned case until they have reviewed everything, but have to answer/take calls in between so there isn't a set time period.
They seem to have been nice to me so far, these appeals people in DWP. Am I being blindsided into trusting them? c. Is there any likelihood of me just doing another assesment with that higher up appeals person and them looking at my medical evidence, up to them whether they read the 70 page document of my personal statement or not, and me actually being able to have a decision within say 1 day?

Has anyone known of any success stories where just before the tribunal hearing, DWP have awarded the PIP appeal claim to the person?
d- Apparently, they also call you to discuss if they are awarding you too, in case for example they only award you X amount and you were expecting Y, therefore, you can reject their proposal and decide to go ahead with the tribunal hearing. If it happens that I am in this aforementioned position whereby say for example I only get the standard daily living rate, instead of enhanced, and same for mobility- shall I just cut my losses and accept it for the sake of actually getting an award (better than nothing) or should I pursue further to thew tribunal (risk loosing everything I've waited literally a year for this and it's been 1 year since I submitted my original claim to DWP to begin with).

Sorry for the very long post and thank you to anyone and everyone for their time reading this, it means a lot. :)

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2 years 4 months ago - 2 years 4 months ago #273181 by LL26
Replied by LL26 on topic PIP appeal hearing
Hi M,
Sorry to hear of your appeal struggles.

It might be helpful to explain more of the process, which may then put certain things into context.
I presume you mean you have actually filled out a SSCS1 form online? (This is the appeal application form.)

You don't have to fill out specific in depth reasons on the SSCS1. You would usually be told to send in any extra info by a certain date. This is not an absolute time. It's really there to assist DWP in producing the appeal papers. When you send in an appeal, whatever format you use, DWP have to produce the appeal papers within 1 month. This is a bundle of all relevant papers which get sent to you and the tribunal members. It comprises copies of claim form, assessment, SSCS1 MR letter, and all decisions as well as any evidence you have sent in. You can always send in additional evidence if you miss the deadline. The only caveat is that you should really send additional evidence no later than 2 weeks before the hearing, otherwise you run the risk of either the tribunal refusing the evidence - they have to be fair to all parties and DWP may not be able to comment if evidence is late, or more likely the case gets adjourned so it takes even longer to finalise.

When the SSCS1 is done, DWP have to review. Sometimes they make no change, but sometimes, especially if there is overwhelming evidence they do change their decision and agree an award. If DWP decide to change the decision, then the appeal will get closed.However you can still continue with the appeal, but will need to contact the tribunal. (The accompanying letter usually explains what you need to do.) The tribunal will then consider the evidence, all the papers, and any oral evidence and decide. If either DWP or tribunal make an award it will get back dated back to the date of claim. (Or date of last decision/payment date for a renewal.) If this is new claim the claimant needs to prove on balance of probabilities ie more likely than not they should get sufficient points for an award. For renewal, DWP have to show an actual change of circumstances, not just an assessment with a different conclusion! This is called supersession.

Oral hearing - I always ask for this - you will get the chance to give live evidence to the tribunal, it mens you can tell your own story, and the tribunal can ask questions if they need things clarified. Yes, this might seem scary- appellants are often worried they will clam up, not be able to speak, shake or panic, talk gibberish etc. OK this can happen, but if these are the health problems you have described in the claim form etc, then the tribunal get to see or hear this. They can look observe breathlessness, uncertainty, need for prompting etc.

Hearings may well be held face to face now, post Covid, but there are still phone or video hearings which offer the benefits of giving evidence, but may not be as stressful than going to a court room, or other similar building. A paper hearing will only be done on the basis of the combined perwork sent in as part of the bundle or additional evidence.

Dwp are not obliged to obtain GP report. They used to get these routinely, however, DWP have to pay for these but will normally only bother when there is a conflict in diagnosis versus claimant's story. It is unlikely they will get medical evidence to support your claim. I wouldn't worry about insisting DWP get a GP report. Get your own, or just rely on one already sent in.

As stated earlier DWP can change the award, this may lead to a phone offer. It is hard to know whether the offer is right. I guess it depends on how strong your case is. If you were arguing both daily living and mobility and get offered one not the other, and realistic count of points shows you should get both, then the offer may be too low. However, if it is only a remote possibility to get an enhanced award then given the hassle of having a hearing and the wait, then you might wish to accept. But be careful you don't undersell yourself. Legal debate suggests that if DWP can make an award they should do so, and begin paying even if you still appeal fir a higher award. The tribunal will have to explain why they don't agree with DWP if the tribunal felt a lower award was right.

Decision time at this stage should not take too long. Tribunal will start complaining to DWP if either a revised decision or no appeal bundle is sent out in the time limit. You can contact the tribunal if there is more than a month delay. Trib can extend the time or make an order for DWP to complete the paperwork etc. (A Direction) If DWP don't adhere to the time limit, they run the risk of their evidence such as assessment etc being excluded.

You might want to listen to the CD or at least get a friend to do this. If you clearly didn't say certain things it will be apparent from the recording. This is very good ammunition against DWP. Say they must have misheard rather than calling them liars. Otherwise it just gets into an ugly slanging match and the rel issue about your disabilities will get lost somewhere in the crossfire!

I hope this helps and everything is now somewhat clearer.
LL26

Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 2 years 4 months ago by LL26. Reason: Spelling

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