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1 year 9 months ago #278381 by Izzy26
Tribunal or new application was created by Izzy26
I applied for pip on the 3rd November 2022 and i have been having issues with my health for over a year nearly 2 now and finally decided to apply. it got turned down being only awarded 2 points for needing support with making food. I applied for a MR and i have received that through the post - letter dated 3rd March, i got it through on the 20th March. So now i am trying to work out if i am best to apply for a tribunal or apply for a new application. I finally went to the GP in January and they have now referred me to the eating disorder clinic and i am being investigated for ADHD, OCD and autism which i have never been to the GP about before. i only went after i finally accepted i needed help and had applied for pip.

what do you think is best? shall i leave it until the other referrals have been started and start a new application or keep going? i am still just as affected now as i was before any of this, its just that i am getting some help now with getting diagnosed and hopefully medication to help.

also my boyfriend has applied for pip too and he has received a letter saying his initial conversation with PIP will be a video call and then his GP has called to book him in and go through the form with him. Has anyone ever heard of the GP doing this before?

Thank you!

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1 year 9 months ago #278405 by BIS
Replied by BIS on topic Tribunal or new application
Hi Izzy26

If you decide to move on to Appeal, the Tribunal can only look at the information that the DWP had at the time of your assessment and MR. So even if you have been diagnosed with the things you mentioned by the time your appeal comes through, the Tribunal panel would not be able to take any notice of that information.

Also, for PIP to take notice of a person's condition, they have to have had it for three months prior to informing the DWP and that it will continue for the nine following months.

So I think you might want to wait a bit, get the other things underway and have a good look at our comprehensive guide to PIP claims and reviews, so you have plenty of time to gather all the information you have and increase your chances of putting in a successful application. benefitsandwork.co.uk/guides-for-claimants/pip

BIS

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1 year 9 months ago #278475 by LL26
Replied by LL26 on topic Tribunal or new application
Hi Izzy26,
I think you could still apply to the tribunal to appeal, if you wished too.
I don't think it matters particularly when you have been to the doctor's, the real problem is how long you have had the relevant health conditions. I suspect that you have been autistic all your life, and this tends to be a condition from birth. Did the GP say this? ADHD is likely to have happened from birth too. OCD may have come later.
The rules that allow for a claim for PIP say that you need to have had a health condition that limits your ability to perform the descriptor activities for at least 3 months in the past, and that these are likely to continue for a further 9 mths. You might need to get an updated report from your GP if he hasn't mentioned when your disabilities started. There is a lot of information on the internet about the day to day difficulties faces by people with autism face - this might be a good start...www.autism.org.uk/ . I suspect that if you read the life stories you may well relate to these, and realise that you have had similar difficulties for a long time, or perhaps for your entire life. I don't know whether this will be the same for the eating disorder, but no doubt you can think back to when this became a problem, and see how long ago this was.
If you can show that just one health condition that limits your ability commenced over 3 months ago and will last longer than 9 months, then you will fulfil the entry requirement for PIP - it is then a matter of evidence. I can give an example to help make things clearer.
John notices in July 2021 that he is stumbling or falling quite often as he walks, he also has significant body pain. Initially he thinks it could be to do with a recent infection that he has had. However the problem continues, his GP gives medicine, and the infection is finally better. The walking is still bad. The pain is worse. He goes back several times to the GP who now believes the problem is more than just an infection. John applies for PIP in December 2021 as he can't walk very far, and has difficulties with daily living tasks. He is refused and needs to appeal. In the meantime the GP makes a referral to the hospital. In March 2023 proper tests are done, and a diagnosis is made.
The hospital report made in March 2023 can be used because it merely explains the ongoing health problems that John has had since 2021. There is nothing in law that prevents John claiming PIP on the basis of having eg severe leg and body pain that prevents him walking or doing daily living activities. However now he has proof of his severe pain, xrays etc show crumbling joints, severe arthritis etc - this is all explained in the new hospital report. He is allowed to use the new report, because all it does is explain the reasons for his existing health problems.
So...as long as the new medical report just confirms about pre-existing or longstanding health issues this can be used as evidence. If a new health problem arises after the assessment eg such as a broken arm due to a car crash this can not be taken in to consideration, although it might allow you to ask for the original decision to be revised if you now have more disability.
I think on this basis you can appeal, and use the new medical report you have. If you continue with the appeal, it should be done within a month of the date of the MR decision, so I think you are still in time. You can apply on line here www.gov.uk/appeal-benefit-decision/submit-appeal
You can put in a late appeal (up to 13 mths late) but will need to provide good reason. I think you are still in time, and you don't have to day anything more than what you said already at MR. However, you can say you now have medical evidence which you can also scan in an upload. You can refer to descriptors and argue the correct points level if you wish. I find it easier to type the arguments out and upload as a separate document, because typing in the box sometimes comes out all as one long paragraph , even though it is all set out nicely. It is then very difficult to read. If you appeal and succeed you will get paid from the start of your claim. If you decide not to appeal, and make a new claim, then you can only get an award from the start of the second claim, so you could lose out out on some money as a result.

I do think that if you make it clear that the new medical report is only describing old health problems it can be used, but only in those limited circumstances.

I hope this helps.

LL26

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1 year 9 months ago #278548 by Izzy26
Replied by Izzy26 on topic Tribunal or new application
Hi LL26, yeah i was thinking the same of just because i haven't got a formal diagnosis, these issues have always affected me and i cant see it ever changing. Its my brain, not something i can control as such. I am going to appeal to tribunal again and state that although i have had these issues for all my life, i have only just had the courage to reach out to my gp and get some help. Even the report they sent back to me said its not about the condition itself, its about how it affects me. So sod it im going to go for it. I know i need help and pip will be a huge help. Thank you
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1 year 9 months ago #278567 by LL26
Replied by LL26 on topic Tribunal or new application
Hi Izzy26,
You can definitely use 'new' medical report to prove older illness. I found some caselaw that said this!
When confirming an error of law Judge Hemingway in JT v SSWP (PIP) [2018] UKUT 101 (AAC)
(CPIP/3130/2017)
was going through various Directions for the new hearing as follows, discussing evidence
"A. The tribunal must (by way of an oral hearing) undertake a complete
reconsideration of the issues that are raised by the appeal and, subject to the
tribunal’s discretion under section 12(8)(a) of the Social Security Act 1998, any
other issues that merit consideration.
B. In particular, the tribunal must investigate and decide the claimant’s entitlement
to a personal independence payment on his claim that was made on
18 November 2016.

C. In doing so, the tribunal must not take account of circumstances that were not
obtaining at the date of the decision of the Secretary of State under appeal: see
section 12(8)(b) of the Social Security Act 1998. Later evidence is admissible,
provided that it relates to the time of the decision: R(DLA) 2 and 3/01.
" emphasis added

There is no need to worry about inadmissibility of the later statement.

Go for it!

LL26

Nothing on this board constitutes legal advice - always consult a professional about specific problems
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1 year 9 months ago #278594 by Izzy26
Replied by Izzy26 on topic Tribunal or new application
Hi LL26
When you say a medical report how do i get this? I am today waiting for a call from my gp to refer me to the adhd and asd services for assessment and this is only the second time its been mentioned in my medical gp record.

The other evidence i sent with my first pip application and MR were diary entries, a letter from my boyfriend who helps me, eating disorder letter, rheumatology referral letter

Thank you

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