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PIP help please
- kymm
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8 years 10 months ago #136777 by kymm
PIP help please was created by kymm
Hi, my first post here but I wonder if anyone could help me with appealing PIP decision.
I have been receiving PIP at the Standard Rate for both care and mobility for the past year or so. In January 2015 I requested the form to have my circumstances reviewed as my condition has worsened considerably since my first assessment. I received a letter from ATOS saying they would call me for another assessment. In April I received a letter stating the DWP had all the information they needed to make a decision, even though I had not had an assessment!
Today I received my decision letter which says that my PIP would remain at the standard rate for both Care and Mobility. I do not understand how they reached that decision without an assessment and without contacting my Consultant, GP or any other Health Professional.
I wonder if someone could tell me what I should do next as my condition is so much worse than when I had my first assessment over a year ago. My medications have all been increased and I am, in fact, on the highest dose morphine patches now.
I would be so grateful for any help you could give me on the appeals process.
I have been receiving PIP at the Standard Rate for both care and mobility for the past year or so. In January 2015 I requested the form to have my circumstances reviewed as my condition has worsened considerably since my first assessment. I received a letter from ATOS saying they would call me for another assessment. In April I received a letter stating the DWP had all the information they needed to make a decision, even though I had not had an assessment!
Today I received my decision letter which says that my PIP would remain at the standard rate for both Care and Mobility. I do not understand how they reached that decision without an assessment and without contacting my Consultant, GP or any other Health Professional.
I wonder if someone could tell me what I should do next as my condition is so much worse than when I had my first assessment over a year ago. My medications have all been increased and I am, in fact, on the highest dose morphine patches now.
I would be so grateful for any help you could give me on the appeals process.
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- Gordon
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8 years 10 months ago #136793 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic PIP help please
kymm
Welcome to the forum.
I'm afraid there is no legal requirement for an assessment to be held or for the Assessment Provider (AP) to contact any of the doctors that you supplied information for.
Although you say your condition has worsened did you identify where you would score the extra four points (minimum) that would be required for an Enhanced award?
Secondly, were you able to show that a documented change had occurred since you were last assessed? If the change was not documented this might explain how a Decision was made without the requirement for an assessment.
If you believe that you supplied sufficient information for an Enhanced award to be made then the first stage to challenging the Decision 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 and 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, there will still be one even though you did not have a face to face, 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 for an Enhanced award, 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
Welcome to the forum.
I'm afraid there is no legal requirement for an assessment to be held or for the Assessment Provider (AP) to contact any of the doctors that you supplied information for.
Although you say your condition has worsened did you identify where you would score the extra four points (minimum) that would be required for an Enhanced award?
Secondly, were you able to show that a documented change had occurred since you were last assessed? If the change was not documented this might explain how a Decision was made without the requirement for an assessment.
If you believe that you supplied sufficient information for an Enhanced award to be made then the first stage to challenging the Decision 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 and 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, there will still be one even though you did not have a face to face, 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 for an Enhanced award, 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
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- kymm
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8 years 10 months ago #136796 by kymm
Replied by kymm on topic PIP help please
Thank you so much Gordon. I will follow your advice and ask for the decision to be reconsidered. Should I send copies of my hospital discharge letters, prescriptions etc when I ask for the reconsideration?
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8 years 10 months ago #136797 by Gordon
You don't have to send anything with the MR Request but you should make it clear that you will be sending further information if that is your intent and that you are also waiting for a copy of the assessment report. They should give you four weeks to do so, but we have had a number of members report that the DWP have made a new Decision before they have had a chance to send this information so you should send it as early as you can.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic PIP help please
kymm wrote: Thank you so much Gordon. I will follow your advice and ask for the decision to be reconsidered. Should I send copies of my hospital discharge letters, prescriptions etc when I ask for the reconsideration?
You don't have to send anything with the MR Request but you should make it clear that you will be sending further information if that is your intent and that you are also waiting for a copy of the assessment report. They should give you four weeks to do so, but we have had a number of members report that the DWP have made a new Decision before they have had a chance to send this information so you should send it as early as you can.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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