Incomplete PIP decision letter

Hi, I'm really hoping someone can help me. I have been refused PIP after being on Higher rate DLA for 5 years, and have had my mandatory reconsideration turned down.

After reading the guides here, I am under the impression that the letter should have separate sections about my illnesses, medicine, evidence submitted etc, eg a "History" section - it doesn't. There is absolutely nothing about my illnesses or anything. All hat is there, is a section on page 2 called "Decision Makers Reasoning" with a long paragraph that says "I made my decision using info about your illnesses and disabilities including details of any treatment, medication, test results and symptoms.....but she hasn't listed them? She has just gone over my form and said why I don't get points etc. Following this on page 3 is "how your decision was reached" with Daily Living component and then Mobility Component. Is this my actual medical report, or just a Decision report??? Any help gratefully received.

Susie wrote: Hi, I'm really hoping someone can help me. I have been refused PIP after being on Higher rate DLA for 5 years, and have had my mandatory reconsideration turned down.

After reading the guides here, I am under the impression that the letter should have separate sections about my illnesses, medicine, evidence submitted etc, eg a "History" section - it doesn't. There is absolutely nothing about my illnesses or anything. All hat is there, is a section on page 2 called "Decision Makers Reasoning" with a long paragraph that says "I made my decision using info about your illnesses and disabilities including details of any treatment, medication, test results and symptoms.....but she hasn't listed them? She has just gone over my form and said why I don't get points etc. Following this on page 3 is "how your decision was reached" with Daily Living component and then Mobility Component. Is this my actual medical report, or just a Decision report??? Any help gratefully received.

Hi S,

Welcome to Benefits and Work

It sounds very much like this is the Decision Maker's reasoning for coming to the decision.

The medical report compiled by The PIP Assessor (ATOS or Capita) is known as a PA4 Medical Report, and this should be signed by the PIP Assessor.

This PA4 is then sent to The DWP PIP DM (Case Manager) who refers to that and any other evidence provided by the claimant in coming to their decision.

Have you actually requested the PA 4 Medical Report ?

If not, and you don't already have it, you can request it over the phone :

PIP helpline :
Telephone: 0345 850 3322
Textphone: 0345 601 6677
Monday to Friday, 8am to 6pm

If you don't receive it, you can make a written request.

Now that your MR has failed, if you have the MR Notice letter, you have one month from the date of that letter to directly lodge your appeal with The Tribunal Service (TS) using copy of the MR Notice and the : SSCS 1 Form (Download Link)

Sending Documents to the DWP and The TS

Once your appeal is accepted by The TS, you will receive an Evidence Pack/Bundle which should include all documentation used by The DWP in coming to their decision.

See also : PIP Appeals Guidance.

&

Disability Rights UK Factsheet - Appeals and Mandatory Reconsiderations.

bro58

That's such a help, thank you! I have already received the SSCS form, do I now need to send that with my reasoning for appeal, with all of my medical evidence again, or just the MR notice?

Susie wrote: That's such a help, thank you! I have already received the SSCS form, do I now need to send that with my reasoning for appeal, with all of my medical evidence again, or just the MR notice?

Hi S,

You need to complete and send The SSC1 along with The MR Notice to the appropriate address provided at the bottom of The SSC1 Form.

The process is covered in our " Guide to PIP appeals.

A 25 page detailed guide on challenging PIP decisions through Mandatory Reconsideration and Appeal." on the page that I have provided the link for in my previous post, from around Pages 11/12.

There are also examples of Appeal Submissions on the same page.

You can include copy of evidence that you have already provided in your MR, as just because The DWP failed to amend the decision at MR does not mean that The TS won't find in your favour.

The success rate with PIP MR's is currently pretty poor, and much better at appeal.

See : Crackdown on DLA to PIP challenges means failure rates soar.

Unfortunately, you have to go through the MR process before moving forward to appeal.

You should concentrate on identifying which PIP Activities you feel that you qualify under, whilst also highlighting the appropriate Descriptor and corresponding number of points that you should score under each appropriate PIP Activity.

You can then tie in the fact you fulfil a particular PIP Activity/Descriptor with any corresponding medical evidence that you have. (Cross-Reference)

See : PIP Claims Guide. (2nd Link down the page)

PIP Self Test

&

Personal independence payment (PIP) points scoring system.

You do not have to provide an in-depth submission initially, you can safely submit fresh evidence right up until around 10 days before the date of your Tribunal Hearing.

The important thing is to lodge your appeal within the one month deadline to protect your right to appeal.

bro58