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Help please
- Jimmy
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8 years 1 week ago #156505 by Jimmy
Help please was created by Jimmy
My Wife Nicola, has just received her assessment results.
She previously received DLA low rate care and High rate Motability.
The new PIP assessment result is for Enhanced care component and only Standard rate for Motability.
Nicola has had very rare muscle wasting disease from birth called Central Core disease which is a branch of Muscular Dystrophy.
As we explained in the assessment she has great difficulty walking and is frightened to go out unaccompanied for fear of falling, so she doesn't. She is unable to manage steps or kerbs, so public transport is out of the question. In the decision Maker Reasoning she states
"You said you have difficulty with moving around. I agree you have difficulties. You said you have difficulties with planning and following journeys. The mental state examination shows you were fully orientated, you have good cognition, memory and did not require prompting"
The Lady assessor was French, and there was some difficulty on both sides trying to understand and comprehend the meaning of some of the questions and the assessor understanding her response.
Please could you advise on how she goes about applying for Mandatory Reconsideration and any key points my wife should stress in her written letter? As her conditions can only get worse.
Kindest regards Jim.
She previously received DLA low rate care and High rate Motability.
The new PIP assessment result is for Enhanced care component and only Standard rate for Motability.
Nicola has had very rare muscle wasting disease from birth called Central Core disease which is a branch of Muscular Dystrophy.
As we explained in the assessment she has great difficulty walking and is frightened to go out unaccompanied for fear of falling, so she doesn't. She is unable to manage steps or kerbs, so public transport is out of the question. In the decision Maker Reasoning she states
"You said you have difficulty with moving around. I agree you have difficulties. You said you have difficulties with planning and following journeys. The mental state examination shows you were fully orientated, you have good cognition, memory and did not require prompting"
The Lady assessor was French, and there was some difficulty on both sides trying to understand and comprehend the meaning of some of the questions and the assessor understanding her response.
Please could you advise on how she goes about applying for Mandatory Reconsideration and any key points my wife should stress in her written letter? As her conditions can only get worse.
Kindest regards Jim.
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- Gordon
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8 years 1 week ago #156540 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic Help please
Jimmy
The PIP Mobility criteria are significantly tougher than those for DLA, in these terms a Standard award has basically the same criteria as DLA HRM.
The Going Out activity covers claimants with cognitive, mental health or sensory issues, so your wife is unlikely to score points if the underlying cause of her anxiety is a physical one (falling over).
So before asking for a Mandatory Reconsideration you really need to look at where she may be able to score the extra points from?
If she is only likely to score for the Moving Around activity then to meet the criteria for an Enhanced award she will need to show that she cannot stand and then move more than 20m.
If you want to pursue an MR then first stage to challenging a 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, 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 she meets the criteria for Enhanced Mobility, there are many reasons she 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 she walked 50m, she did but they have failed to document that she 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
The PIP Mobility criteria are significantly tougher than those for DLA, in these terms a Standard award has basically the same criteria as DLA HRM.
The Going Out activity covers claimants with cognitive, mental health or sensory issues, so your wife is unlikely to score points if the underlying cause of her anxiety is a physical one (falling over).
So before asking for a Mandatory Reconsideration you really need to look at where she may be able to score the extra points from?
If she is only likely to score for the Moving Around activity then to meet the criteria for an Enhanced award she will need to show that she cannot stand and then move more than 20m.
If you want to pursue an MR then first stage to challenging a 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, 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 she meets the criteria for Enhanced Mobility, there are many reasons she 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 she walked 50m, she did but they have failed to document that she 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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- Jimmy
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8 years 1 week ago #156661 by Jimmy
Replied by Jimmy on topic Help please
Hello Gordon,
Thank you for your reply, very much appreciated.
Bit of a sticky problem, my Wife is very upset at having to try show and prove to complete strangers that she is disabled after living for 50 years with Central Core Disease, which is a branch of Muscular Dystrophy. It has been diagnosed by rare disease Consultants and will never get better only worse as years go by.
She is a very proud Lady and always tries to get over her disabilities and it is very sad that the DWP have taken her Motability award away from her.
Nicola has become one of the Governments victims, pick on the poorest disabled people who do not have the fight to challenge them.
As I understand a Mandatory re- decision will mean looking at her claim again in Full ??? Is it possible to just write to them and ask to look at the Motability section ?? she scored 16 in the care section but only scored 10 points in the 2nd part of getting around section, but they have dismissed some of the answers in the first section of getting around.
She is very upset, saying that it is like a DWP Freak show.
This same problem going to affect me soon, I have received Motability and Standard rate care DLA since 1995.
I am at stage 5 renal failure and have been told that when I start dialysis my life expectancy will be 3.9 years average. Some people they say last 12 months and others 7 years.
I have no use in both shoulders and a ruptered bicep muscle in my right arm from an accident at work.
My left leg was shattered in a motorcycle head on crash and I walk with a very bad limp. My right leg has serious vascular problems and I take Warfarin for my DVT.
My orthopaedic Consultant says he can not operate to fix my torn knee cartilage or give me a new hip joint because of my kidney disease. I am classed as AO, meaning awaiting operation.
I constantly take strong pain killers during the day and a very strong Oxycodone liquid during the night.
My worry is what do I do at my assessment when it arrives ??
Kindest regards
Jim.
Thank you for your reply, very much appreciated.
Bit of a sticky problem, my Wife is very upset at having to try show and prove to complete strangers that she is disabled after living for 50 years with Central Core Disease, which is a branch of Muscular Dystrophy. It has been diagnosed by rare disease Consultants and will never get better only worse as years go by.
She is a very proud Lady and always tries to get over her disabilities and it is very sad that the DWP have taken her Motability award away from her.
Nicola has become one of the Governments victims, pick on the poorest disabled people who do not have the fight to challenge them.
As I understand a Mandatory re- decision will mean looking at her claim again in Full ??? Is it possible to just write to them and ask to look at the Motability section ?? she scored 16 in the care section but only scored 10 points in the 2nd part of getting around section, but they have dismissed some of the answers in the first section of getting around.
She is very upset, saying that it is like a DWP Freak show.
This same problem going to affect me soon, I have received Motability and Standard rate care DLA since 1995.
I am at stage 5 renal failure and have been told that when I start dialysis my life expectancy will be 3.9 years average. Some people they say last 12 months and others 7 years.
I have no use in both shoulders and a ruptered bicep muscle in my right arm from an accident at work.
My left leg was shattered in a motorcycle head on crash and I walk with a very bad limp. My right leg has serious vascular problems and I take Warfarin for my DVT.
My orthopaedic Consultant says he can not operate to fix my torn knee cartilage or give me a new hip joint because of my kidney disease. I am classed as AO, meaning awaiting operation.
I constantly take strong pain killers during the day and a very strong Oxycodone liquid during the night.
My worry is what do I do at my assessment when it arrives ??
Kindest regards
Jim.
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- Gordon
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8 years 1 week ago #156676 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic Help please
JImmy
Although you can ask that any MR only looks at the Mobility component, the DWP are not obliged to follow your request. If she scored 16 points then it's likely that the Daily Living component is secure but I cannot offer a 100% guarantee of this.
The other side of the coin is whether you can show that she meets the criteria for an Enhanced award? If you are unsure of this then this is something to consider as part of your decision.
As to your being asked to claim PIP at some time in the future.
All I can say is that you need to explain your problems as they are at that time, make sure that you understand the criteria against which you are being assessed against, whilst you are not required to complete an activity pain free, any pain that restricts your ability to complete the activity must be taken into account, this comes under the broad headings of "reliably" and "for the majority of days", both terms are explained in the PIP Claim guide.
Gordon
Although you can ask that any MR only looks at the Mobility component, the DWP are not obliged to follow your request. If she scored 16 points then it's likely that the Daily Living component is secure but I cannot offer a 100% guarantee of this.
The other side of the coin is whether you can show that she meets the criteria for an Enhanced award? If you are unsure of this then this is something to consider as part of your decision.
As to your being asked to claim PIP at some time in the future.
All I can say is that you need to explain your problems as they are at that time, make sure that you understand the criteria against which you are being assessed against, whilst you are not required to complete an activity pain free, any pain that restricts your ability to complete the activity must be taken into account, this comes under the broad headings of "reliably" and "for the majority of days", both terms are explained in the PIP Claim guide.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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- Jimmy
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7 years 11 months ago #158277 by Jimmy
Replied by Jimmy on topic Help please
Hello Gordon,
We have decided to have a go at the reconsideration.
Do we just write a simple letter explaining why we disagree with the decision or is there a sample letter to follow of some kind ??
Also trying to obtain more medical evidence to go with the reconsideration.
Kind regards Jim.
We have decided to have a go at the reconsideration.
Do we just write a simple letter explaining why we disagree with the decision or is there a sample letter to follow of some kind ??
Also trying to obtain more medical evidence to go with the reconsideration.
Kind regards Jim.
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- Gordon
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7 years 11 months ago #158304 by Gordon
There's a template letter you can use in the PIP Appeal Submissions document in the PIP area.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic Help please
Jimmy wrote: Hello Gordon,
We have decided to have a go at the reconsideration.
Do we just write a simple letter explaining why we disagree with the decision or is there a sample letter to follow of some kind ??
Also trying to obtain more medical evidence to go with the reconsideration.
Kind regards Jim.
There's a template letter you can use in the PIP Appeal Submissions document in the PIP area.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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