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Is this grounds for challenging PIP review?
- AlwaysPacing
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1 year 10 months ago #278148 by AlwaysPacing
Is this grounds for challenging PIP review? was created by AlwaysPacing
Please help me to understand whether the following are grounds for challenging my PIP review:
I successfully applied for PIP in 2020. Was asked to complete a form updating on any changes in January 2022. In March 2023 (last week) they invited me for a video consultation (which became a phone one due to technical hitches). I have requested a copy of the assessment report and which says 6 for daily living; and 4 for mobility (which doesn't meet Standard requirements).
a) I have not yet received the decision as this is the report, but am I right in assuming the decision will echo the report?
b) Would the following be grounds for appeal / worth raising, and is there a deadline to appeal (the phonecall was on 14 March, the letter is dated 15 March and the letter with the report was delivered 18 March):
1: History of conditions says 'Has attended lifestyle management from Chronic Fatigue Service in 2019. This should say 'since 2019'. It also says 'counselling in 2020' however I told them 2 years. It says 'no current specialist input or planned reviews' however I said I attend regular group sessions with the CFS service (these are in place of what was previously 1:1 appointments pre-pandemic, and I can always request a 1:1 however I didn't spell that out). Later in Managing Therapy or Monitoring a Health Condition this is worded slightly differently - see (3) below.
2. Social and Occupational History says my PA is contracted up to 20 hours per month. This should be a minimum of 20hours per month, can be up to 40. Also says 'Adjustments in place since returning to work in Jan 2021, prior to that was off work and unwell for up to 2 years' - I said 'for 2 years' not 'up to'.
3. Managing therapy or monitoring a health condition says 'In the past she attended appointments with a regional ME Service' however this is ongoing (I attend group video sessions monthly but can also request 1:1 appointments).
4. Observations section - General appearance and informal observations - feels unfair - 'did not require any breaks': I would have taken a break but my PA was only available for a limited time for the call, and we'd started late due to technical hitches on the part of DWP (not me); and it was unclear how many more questions there were to go. I felt if I didn't keep going I might run out of PA time to support the call. I did not explain this at the time.
5. Observations section - Mental state - 'Coped well at interview. Not anxious, agitated or tense' - I was anxious but didn't say this. 'was fully alert and orientated throughout assessment' - I felt very brain foggy and exhausted by the end, said this and explained that every time my PA spoke I was resting my brain, closing my eyes, etc.
6. Health professional's opinion - Preparing Food: 'ability to cook while sitting down, able to chop if she has energy consistent with variability showing she is doing tasks when she has the energy for it, therefore assistance is not required' - elsewhere in this section it acknowledges that I spoke of PA / husband assisting. This seems inadequate as it's saying I don't need assistance because I cook when I can - despite the fact I have spoken of others assisting me when I can't?
6. Health professional's opinion - Communicating verbally: 'although her PA was present she did not speak on her behalf'. It is accurate to say I spoke, however I did turn to my PA at almost every question, asking her to add things I had forgotten or to help me articulate. Frequently she raised things I hadn't / phrased them more clearly and I agreed.
7. Making budgeting decisions - cites various things (returned to work 5 days a week, driving, no cognitive impairment or mental health condition, aware when she is struggling and delegates to others, writing things down and planning in advance) as 'suggests she should be able to reliably manage complex budgeting decisions independently'. However earlier on they note from the call that I have made financial mistakes in work, have support from colleagues; need support from parents or partner for complex budgeting; need to wait for a better health day to do a task' so I don't understand why they are saying I can do this independently (or what relevance it is that I can drive / spread my shifts over 5 days / delegate etc.)
I also feel I should get more points in the following areas:
Preparing food - I have 'needs to use an aid or appliance' but I also spoke of needing someone to write instructions and / or explain recipes to me, remind me how to do it safely, and remind me if doing something unsafe e.g. putting metal in microwave. Therefore I think I should get 'needs supervision or assistance'.
'Engaging with others face to face' - I scored zero. However reported needing someone to advocate for me re: pacing, having difficulty mixing for long / anywhere very noisy or with lots of people, difficulty word finding, and having to entirely avoid some social situations as wouldn't cope - therefore I feel it is 'needs social support'.
'Making budgeting decisions' - see note 7 above.
I successfully applied for PIP in 2020. Was asked to complete a form updating on any changes in January 2022. In March 2023 (last week) they invited me for a video consultation (which became a phone one due to technical hitches). I have requested a copy of the assessment report and which says 6 for daily living; and 4 for mobility (which doesn't meet Standard requirements).
a) I have not yet received the decision as this is the report, but am I right in assuming the decision will echo the report?
b) Would the following be grounds for appeal / worth raising, and is there a deadline to appeal (the phonecall was on 14 March, the letter is dated 15 March and the letter with the report was delivered 18 March):
1: History of conditions says 'Has attended lifestyle management from Chronic Fatigue Service in 2019. This should say 'since 2019'. It also says 'counselling in 2020' however I told them 2 years. It says 'no current specialist input or planned reviews' however I said I attend regular group sessions with the CFS service (these are in place of what was previously 1:1 appointments pre-pandemic, and I can always request a 1:1 however I didn't spell that out). Later in Managing Therapy or Monitoring a Health Condition this is worded slightly differently - see (3) below.
2. Social and Occupational History says my PA is contracted up to 20 hours per month. This should be a minimum of 20hours per month, can be up to 40. Also says 'Adjustments in place since returning to work in Jan 2021, prior to that was off work and unwell for up to 2 years' - I said 'for 2 years' not 'up to'.
3. Managing therapy or monitoring a health condition says 'In the past she attended appointments with a regional ME Service' however this is ongoing (I attend group video sessions monthly but can also request 1:1 appointments).
4. Observations section - General appearance and informal observations - feels unfair - 'did not require any breaks': I would have taken a break but my PA was only available for a limited time for the call, and we'd started late due to technical hitches on the part of DWP (not me); and it was unclear how many more questions there were to go. I felt if I didn't keep going I might run out of PA time to support the call. I did not explain this at the time.
5. Observations section - Mental state - 'Coped well at interview. Not anxious, agitated or tense' - I was anxious but didn't say this. 'was fully alert and orientated throughout assessment' - I felt very brain foggy and exhausted by the end, said this and explained that every time my PA spoke I was resting my brain, closing my eyes, etc.
6. Health professional's opinion - Preparing Food: 'ability to cook while sitting down, able to chop if she has energy consistent with variability showing she is doing tasks when she has the energy for it, therefore assistance is not required' - elsewhere in this section it acknowledges that I spoke of PA / husband assisting. This seems inadequate as it's saying I don't need assistance because I cook when I can - despite the fact I have spoken of others assisting me when I can't?
6. Health professional's opinion - Communicating verbally: 'although her PA was present she did not speak on her behalf'. It is accurate to say I spoke, however I did turn to my PA at almost every question, asking her to add things I had forgotten or to help me articulate. Frequently she raised things I hadn't / phrased them more clearly and I agreed.
7. Making budgeting decisions - cites various things (returned to work 5 days a week, driving, no cognitive impairment or mental health condition, aware when she is struggling and delegates to others, writing things down and planning in advance) as 'suggests she should be able to reliably manage complex budgeting decisions independently'. However earlier on they note from the call that I have made financial mistakes in work, have support from colleagues; need support from parents or partner for complex budgeting; need to wait for a better health day to do a task' so I don't understand why they are saying I can do this independently (or what relevance it is that I can drive / spread my shifts over 5 days / delegate etc.)
I also feel I should get more points in the following areas:
Preparing food - I have 'needs to use an aid or appliance' but I also spoke of needing someone to write instructions and / or explain recipes to me, remind me how to do it safely, and remind me if doing something unsafe e.g. putting metal in microwave. Therefore I think I should get 'needs supervision or assistance'.
'Engaging with others face to face' - I scored zero. However reported needing someone to advocate for me re: pacing, having difficulty mixing for long / anywhere very noisy or with lots of people, difficulty word finding, and having to entirely avoid some social situations as wouldn't cope - therefore I feel it is 'needs social support'.
'Making budgeting decisions' - see note 7 above.
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- BIS
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1 year 10 months ago #278161 by BIS
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by BIS on topic Is this grounds for challenging PIP review?
Hi AlwaysPacing
I'm sorry that you find yourself in this position.You could write to the Decision Maker now and challenge all the points you have made before the decision comes out. However, you only have a small window of time, and you need to do it in the next couple of days. Say that you reserve the right to put in for It won't stop you from putting in for a Mandatory Decision after you have received the decision letter.
You have four weeks from the date in the decision letter to put in for a Mandatory Reconsideration. The decision maker generally follows the advice of the HP (Health Professional), although you cannot be certain until you receive the decision letter.
One thing you should do is look at our 4 guides - to PIP Appeals . benefitsandwork.co.uk/guides-for-claimants/pip It will be particularly worth you looking at how to challenge medical information.
I can't tell you whether you have grounds for your Mandatory Reconsideration - that's a decision that everyone has to make for themselves, but I will comment on some of the issues you raise.
I know it is irritating that some of the information isn't quite accurate, but even if you tell them that the comment 'counselling in 2020' is inaccurate - because you told them 2 years, it won't actually make any difference to any award you're given. Nor will it matter if they missed off that you can request 1 to 1 appointments, especially if you've never requested them.
The points given for each question is what makes up the award, so don't get bogged down on those errors that won't affect your award. Focus on all the specific PIP criteria. (I'm not saying you shouldn't mention errors, but I think it's best saved for one paragraph at the end of the letter).
So questions - like Preparing Food. It's always difficult for people with varying condition/s. I don't know what you originally said, but in order to be awarded points, you need to show that you need help for the majority of days eg 4 out of 7. I don't know how often you said you try to prepare food. If you never prepare it alone, or you always have to have some additional assistance - then say so. Say that the assessor was mistaken in their belief if they got it wrong. Make sure that you have covered every aspect of the Preparing Food question as it sets out in The Guide to PIP claims and reviews. benefitsandwork.co.uk/guides-for-claimants/pip
Managing Money - complex budgeting - have a look at the guide to PIP claims and review - page 57. There is information about a court case and a claimant being unable to do five things that account for this. Have a look and see if any of it applies to you. I think you should emphasise the fatigue and the cognitive dissonance associated with having CFS. that would have an impact in this area.
Engaging with others - In order to score here you have to make sure that you have linked the difficulties you have with your condition. You have to say why your CFS makes this difficult - things like exhaustion, balance issues, cognitive dissonance (brain fog) etc and all the difficulties this brings and why you may avoid having contact with people outside of work.
You know yourself and what you can and can't do. Go back and see every point where you think you should score more points and you haven't, and see how you can challenge their assumptions, their errors, their omissions.
Come back and ask if you have any further questions.
BIS
I'm sorry that you find yourself in this position.You could write to the Decision Maker now and challenge all the points you have made before the decision comes out. However, you only have a small window of time, and you need to do it in the next couple of days. Say that you reserve the right to put in for It won't stop you from putting in for a Mandatory Decision after you have received the decision letter.
You have four weeks from the date in the decision letter to put in for a Mandatory Reconsideration. The decision maker generally follows the advice of the HP (Health Professional), although you cannot be certain until you receive the decision letter.
One thing you should do is look at our 4 guides - to PIP Appeals . benefitsandwork.co.uk/guides-for-claimants/pip It will be particularly worth you looking at how to challenge medical information.
I can't tell you whether you have grounds for your Mandatory Reconsideration - that's a decision that everyone has to make for themselves, but I will comment on some of the issues you raise.
I know it is irritating that some of the information isn't quite accurate, but even if you tell them that the comment 'counselling in 2020' is inaccurate - because you told them 2 years, it won't actually make any difference to any award you're given. Nor will it matter if they missed off that you can request 1 to 1 appointments, especially if you've never requested them.
The points given for each question is what makes up the award, so don't get bogged down on those errors that won't affect your award. Focus on all the specific PIP criteria. (I'm not saying you shouldn't mention errors, but I think it's best saved for one paragraph at the end of the letter).
So questions - like Preparing Food. It's always difficult for people with varying condition/s. I don't know what you originally said, but in order to be awarded points, you need to show that you need help for the majority of days eg 4 out of 7. I don't know how often you said you try to prepare food. If you never prepare it alone, or you always have to have some additional assistance - then say so. Say that the assessor was mistaken in their belief if they got it wrong. Make sure that you have covered every aspect of the Preparing Food question as it sets out in The Guide to PIP claims and reviews. benefitsandwork.co.uk/guides-for-claimants/pip
Managing Money - complex budgeting - have a look at the guide to PIP claims and review - page 57. There is information about a court case and a claimant being unable to do five things that account for this. Have a look and see if any of it applies to you. I think you should emphasise the fatigue and the cognitive dissonance associated with having CFS. that would have an impact in this area.
Engaging with others - In order to score here you have to make sure that you have linked the difficulties you have with your condition. You have to say why your CFS makes this difficult - things like exhaustion, balance issues, cognitive dissonance (brain fog) etc and all the difficulties this brings and why you may avoid having contact with people outside of work.
You know yourself and what you can and can't do. Go back and see every point where you think you should score more points and you haven't, and see how you can challenge their assumptions, their errors, their omissions.
Come back and ask if you have any further questions.
BIS
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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