PIP Appeal Hearing & ESA reassessment both in Feb

Both letters hit the mat on the same day: double whammy of stress.

I prepared the Appeal papers with the help of this website - thank you - and the Hearing date has been set for only 2 1/2 months after appeal submission (to help give an idea of timeline to other people).

I'm now about to work through your ESA guidelines for both physical & mental health issues.

My main question is: should I mention the PIP application & appeal in the fresh ESA50 (3 years since my last one when placed in support group)? I can see there may be DWP statements acknowledging my health issues in the Appeal bundle: but could this prejudice my ESA reapplication?

I will of course mention and provide copies of my doctor's referral to the hospital specialist and I am currently an outpatient with a forthcoming appointment..

Thanks in advance for any feedback.

ivyfox wrote: Both letters hit the mat on the same day: double whammy of stress.

I prepared the Appeal papers with the help of this website - thank you - and the Hearing date has been set for only 2 1/2 months after appeal submission (to help give an idea of timeline to other people).

I'm now about to work through your ESA guidelines for both physical & mental health issues.

My main question is: should I mention the PIP application & appeal in the fresh ESA50 (3 years since my last one when placed in support group)? I can see there may be DWP statements acknowledging my health issues in the Appeal bundle: but could this prejudice my ESA reapplication?

I will of course mention and provide copies of my doctor's referral to the hospital specialist and I am currently an outpatient with a forthcoming appointment..

Thanks in advance for any feedback.

Hi if,

Welcome to Benefits and Work Forum

As you have been a Member since November last year, I will assume that you know where to find all our ESA & PIP Guidance/Resources.

If not, please let us know.

Although the qualifying criteria for PIP and ESA are totally different with a few cross-overs, you can use any evidence that you have that is wholly supportive of your PIP Appeal and/or your ESA Re-assessment.

Here is some generic advice on PIP MR/Appeals that I provide to all members going through a PIP MR/Appeal and even if you have already gone through The MR process, hopefully you will find some of the information helpful. :

You have one month from the date of the PIP Decision Notice letter to make a written request for a Mandatory Reconsideration (MR) of the PIP decision.

Sending Documents to the DWP.

You could also ring the PIP Helpline :

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

To request a copy of The PA4 PIP Medical Report compiled by the PIP Assessor at your face to face and sent to The DWP PIP DM to be used when the DM came to their decision.

If you have any problems obtaining The PA4 with a verbal request, you can make a written request which should be done as a separate issue to any MR request :

You can do this using a SAR Form :

SAR Form Download

From this page :

DWP Data Protection Policy

Or you can make the request in the form of a letter, as long as you make it clear that you are making a formal SAR under The Data Protection Act 1998.

Address the envelope : FAO The Data Controller, at the Benefits Office dealing with your PIP.

Write DPA 1998 SAR in front, top, left corner of envelope.

Once received, they have 40 calendar days to comply.

You should not miss your one month deadline if The PA4 has not arrived.

You can make comment that you have requested this and will submit further evidence if applicable when you receive it.

You should be aware that when you request an MR, any current PIP Awards, Daily Living and/or Mobility, that you might have, can be increased, reduced or taken away altogether, as they will look at the whole PIP Awards afresh.

Obviously if you have no current PIP Award, there is no risk involved.

See : PIP MR/Appeals Guidance.

Disability Rights UK Factsheet - Appeals and Mandatory Reconsiderations.

Once you have gone through The MR Process, if you are still unsuccessful, you have one month from the date of The MR Decision Notice Letter to appeal directly to The Tribunal Service. (TS)

You should do this using copy of The MR Notice letter and the : SSCS 1 Form (Download Link)

All this is explained in our PIP Appeals Guidance

In the MR request and any subsequent Appeal you should concentrate on reiterating where and why you should have scored the extra points with respect to the applicable PIP Activities and the appropriate scoring PIP Descriptor for that Activity, whilst cross-referencing to any medical evidence that you have, or may have already provided that indicates/supports the fact that you should have.

You should take into account that the PIP DM is not medically qualified at all, so the easier that you can make it for them to understand the limitations that you suffer as a result of your medical conditions, and how those limitations score you the required points under the appropriate scoring PIP Descriptor for each applicable PIP Activity, the better your chance of success.

Once you have the PA4, you can pose any counter arguments to the PIP Assessors recommendations in The PA4.

e.g. If they are stating that you can carry out a particular PIP Activity, has it been taken into account that to be classed as being able to carry out a PIP Activity, you must be able to do so Reliably and Safely for The Majority of Days

If the Assessor has stated that they witnessed you Walking a set distance have they taken into account the above, the time it took you to do so, and any pain, discomfort and breathless, etc that you may have suffered whilst doing so ? etc, etc, etc !!

Try and keep you counter arguments relevant to The PIP Activities/Descriptors where you would have expected to score points or more points than you were actually awarded.

See also : PIP Self Test

PIP Points Scoring System

&

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

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With regards to your ESA re-assessment, you might want to consider :

Using The PDF Version Of The ESA50 Questionnaire

Whilst referring to the guides on this page, 2nd & 3rd links down :

ESA Claims Guides

See also :

How long do I have to complete the ESA50?

ESA50 too big for the envelope

&

Sending Documents to the DWP or Maximus. (aka CHDA, aka HAAS.)

As with any re-assessment is important that you treat it as if it was your first assessment, and you should not assume that The Assessor has any access to evidence that you provided in your previous assessment.

They may not even be aware which "Group" you are currently in, especially as it is now a different company who carry out the Assessment/Re-assessments, namely : The Centre for Health and Disability Assessments (CHDA) (aka HAAS) (Maximus) who took over the ESA WCA Contract from ATOS on 02/03/15.

So you may wish to highlight and reiterate the reasons why you are in the SG !

You need to make it clear that your medical conditions and resulting limitations have not changed/improved since your last assessment to such an extent that you no longer qualify for The SG and that you have not been able to better cope with, or adapt to said limitations since that time.

They will be "Re-assessing" your ESA qualification on how you are at the time, not how you were at you previous ESA assessment.

You might want to Bookmark/Favourite this page in your Internet Browser. That way you can return to this topic easily to pose any further queries that you may have by replying to the topic.

bro58

Hi if,

You can safely submit evidence to The Tribunal until around 7-10 days before your PIP Appeal Hearing.

Looking "forward", : Here. is some information and the personal experiences of a member who recently won their PIP Appeal !

bro58

An update with good news.

Firstly, I prepared an extremely comprehensive ESA50 thanks to your guides and posted it in good time. The postal clerk said I could either post it for free with a Certificate of Posting or pay the full Recorded Delivery/Signed For fee.

I attended the Hearing of my PIP Appeal in Watford on Tuesday. The stress levels reached new heights but I felt strangely calm when I went in to the Tribunal with my friend as a witness. I was appealing on the principal ground of 'Managing Toilet Needs' as I have faecal incontinence and was awarded zero points for this at assessment, but 6 for other daily living sections, i.e. I was 2 points short of the basic award. I also have anxiety, panic and depression issues but my PIP application focussed mainly on the physical aspects.

All the panel were female, as am I: my friend is male. I was closely questioned for about an hour in intimate detail: the judge was matter-of-fact, the doctor was polite, professional and thorough, but the disability panellist asked vague questions and wanted me to speculate on what I would be able to do with the 'right' incontinence protection. She wanted to know why I hadn't been shown a range of incontinence protection. More worryingly, she stated she knew I used social media and why hadn't I mentioned such-and-such a friend? I broke down and sobbed a couple of times in shame and self-disgust. My witness spoke twice, to comfort and confirm what I said, and finally he stated I had rung to ask him to help me clean up. By now it was late afternoon; I was told the decision would be made, typed up and sent by first-class post.

Today I learned I have been awarded Daily Living at the basic rate on 10 points: the 6 not in dispute plus 4 points for 'Managing Toilet Needs'. The award is backdated to June 2015 when I applied and lasts for 3 years.

Thank you so much all at Benefits and Work for your information, support and own stories. I wouldn't have had the courage to go this far without you. I made the application 'on my own' and took out a subscription after Mandatory Reconsideration for guidance to Appeal.

Now I just have to wait to see if I'm called for assessment by Maximus for ESA...

Well done on seeing this through Ivyfox! I'm very glad that the tribunal found in your favour. thanks for letting us know and for your kind words about B+W