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DLA stopped for 'failure to attend' PIP medical

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6 years 8 months ago #196415 by Alice10
Please can I ask for advice on putting in an appeal about my PIP claim (transferring from DLA which I have been on since 2003 since my condition was considered ‘unlikely to improve’)? It’s a little unusual because I’m not appealing because I got insufficient points at my face-to-face. It’s because my benefit was stopped because I ‘failed to attend’. I will explain.

I was sent an appointment date and the location was in a city 20 miles from me which I am unfamiliar with and would find it difficult to get to. I stated on my PIP form that I have difficulty going to unfamiliar places and that I would need to have someone accompany me due to my health condition. I knew it was possible to rearrange the appointment once so I called and arranged another appointment nearer to where I live, and on a date where the person who had offered to accompany me would be able to come. It then turned out the person accompanying me had double booked herself and couldn’t come. I rang to see if they would give me another appointment but they wouldn’t, only 2 are allowed. I said I couldn’t attend by myself, and they (Atos) said they would have to return my paperwork to the DWP for them to decide whether I would be granted another appointment, but they were hopeful that they would be sympathetic as I wouldn’t be able to attend without someone to accompany me. Atos said they would pass on what I had told them. I also put it in writing myself why I hadn’t been able to attend, and asked again for a paper-based assessment (as I did on my PIP form), because a face to face would cause a worsening of my condition. My health worker (not the same person who had offered to come with me) also wrote to say it would cause me extreme difficulty to attend alone and would be detrimental to my health.

I then received a letter saying my DLA had been stopped because I had failed to attend. I checked they had received the two letters, mine and my health workers, and they had. So they had made the decision despite what I’d told them. My DLA was stopped in June.
I asked for advice in a forum I use about what to say and put in a request for Mandatory Reconsideration (don’t know why it slipped my mind to ask for advice here!). This was unsuccessful.

I now have the option to appeal the decision.

When I put in for Mandatory Reconsideration I used the criteria the DWP give for deciding whether someone has given ‘good reason’ for not attending, and is entitled to a further appointment. This is the document www.gov.uk/government/uploads/system/upl...ile/473399/admp6.pdf I feel they haven’t abided by their own rules in doing the MR, but then we know they have targets for rejecting people at the MR stage, and forcing people to go to appeal.

Please can you give me any advice on what I should say/do in my appeal? If there is further info that would be helpful (about my health condition, or what I said in my PIP form, previous letters about my appointment, my MR etc), I can tell you more.

I wondered whether I should go to the CAB and ask for their help in preparing my appeal so I can show I’ve needed help with doing this. But I have had very good advice from B&W previously (when I had a problem with ESA being stopped in error) and would prefer to go by your advice if possible.

Thanks for any help you can give me.

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6 years 8 months ago #196429 by Gordon
Alice

There's really not much advice we can offer, this us about your explaining why you were unable to attend and for the panel to decide whether they accept these and whether they consider them to be adequate reasons for you not attending the assessment.

From your post you argument hinges on your being unable to attend alone so I would concentrate on this primarily, it may be that your PIP2 and evidence covers this in sufficient detail, but I would still go back through it to ensure that this is the case.

You can certainly mention asking for a PBR but as one was not granted the panel may decide that it is not relevant to your appeal.

|One thing that you should consider asking the panel for, is a directive to the DWP to reinstate your DLA claim, there normal position is that they will not do this, rather backdating the PIP claim to the day after your DLA was stopped. Although this a decision that can be overturned, it will be easier if it can be avoided in the first place and a Tribunal direction will help with this.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
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6 years 8 months ago #196487 by Alice10
Thanks. I think that helps focus my mind a bit better on what I need to say. In some ways I feel I'll be appealing to their (DWP's) 'better nature' in allowing me to have a further appointment (or at least the tribunal panel's), and was doing in my MR, as it's all down to interpretation of the rules, and whether it's done with any flexibility/benefit of the doubt or not. Hopefully the panel will be more understanding/give more benefit of the doubt. I think the DWP tend to interpret the rules in the strictest way they can.

Thanks for mentioning requesting the directive to reinstate my DLA, I will try that. Also to argue again for a PBR. I know of someone who kept asking for a home visit and ended up with a PBR instead, so sometimes the DWP change tack on this sort of thing.

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6 years 5 months ago #202367 by Alice10
Hi, I did put in an appeal, and now I'm looking for further advice on what's happened since please.

After I put in my appeal, out of the blue I was sent a new appointment for a PIP assessment from Atos.

So I thought, great, my appeal must have been successful. The DWP must have decided that I had given 'good reason' for failing to attend, and decided to reopen my PIP claim, and give me a new assessment appointment. I expected to hear nothing further about the appeal, and hoped my stopped DLA would be reinstated.

But no, I got a letter from the Tribunal people saying it was going ahead. I rang them to query it, telling them the DWP had relented, and the appeal was no longer necessary as I no longer needed to argue my case for a new assessment as I'd been given one. But they said they would have to hear from the DWP that the appeal was no longer necessary, and they hadn't.

I then rang the DWP to say 'the appeal's not necessary now, and can I have my DLA reinstated'. But they told me I will still have to appeal against them stopping my DLA. This makes no sense to me! They've admitted I'm entitled to a new assessment. They are no longer (presumably) saying I failed to attend without giving good reason. But the person I spoke to told me that only a tribunal judge can make the decision to reinstate my DLA. I can't get my head round this, it doesn't seem logical (not that the DWP have a great track record on being logical :huh: ).

So, my question is, are the DWP correct? Do I have to go to a tribunal to argue that they should reinstate my DLA (because DLA usually continues to be paid whilst you are in the process of applying for PIP, which I am), which was stopped when I 'failed to attend', even though they've now overturned the 'failure to attend' decision and decided I gave a good reason, so qualify for a new appointment after all?

(I've had my assessment now, and am waiting for the outcome. If (big if :unsure: ) I get awarded PIP, I'm guessing/hoping it will be backdated to when my DLA was stopped, and I won't have to appeal to get it reinstated and the arrears paid to me after all. But if I get awarded nil points and have to appeal, then I still need to know whether they are correct about the current appeal having to go ahead).

I hope this makes sense, it all boggles my head in it's contradictinariess (not a real word I know!).

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6 years 5 months ago #202393 by Gordon
Alice

Are the DWP correct, no but that does not mean that they are going to reinstate your DLA.

The law requires the DLA claim to be closed if the claimant does not meet the requirements of the claim process, so it was correct that your DLA claim was closed when you failed to attend.

However, having accepted your reasons for not attending and sending you to a new assessment, the reasons for your DLA being closed have been removed, the problem is that the DWP don't seem to be able to understand this and refuse to reinstate the DLA.

So I would continue with the appeal for the moment. If you receive a PIP award and it is the same or higher than what you were receiving on DLA then cancel the appeal as having a DLA award will prevent payment of the PIP, which should now be back dated to the day after your DLA was stopped.

If the PIP is lower then pursue the appeal and if successful you should be paid the difference between what you should have received and what you did.

The arguments for your appeal will have changed and you should no longer need to explain why you did not attend, it should be about your having shown Good Cause, which was accepted by the DWP that there is no reason for not reinstating the DLA.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
The following user(s) said Thank You: Alice10

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6 years 5 months ago #202471 by Alice10

Gordon wrote: Alice

Are the DWP correct, no but that does not mean that they are going to reinstate your DLA.

The law requires the DLA claim to be closed if the claimant does not meet the requirements of the claim process, so it was correct that your DLA claim was closed when you failed to attend.

However, having accepted your reasons for not attending and sending you to a new assessment, the reasons for your DLA being closed have been removed, the problem is that the DWP don't seem to be able to understand this and refuse to reinstate the DLA.


I know :blink: ! It's maddening :angry:

Yes, thanks, you're right, there's nothing I can really do except go along with the appeal process, and hope I get awarded some PIP and can then cancel the appeal. I was on low rate care and mobility for DLA, so I think any award of DLA will be higher than that. If I do end up going to appeal, hopefully the judge will quickly see there is no longer any case to answer, and I will be successful. (But if that happens it will be because I've not been awarded any PIP, so I'll have the appeal from that to deal with as well :( ).

Thanks again for your advice, helps to know it's not just me going mad, and that what the DWP are doing is actually illogical. But as you say, they're a law unto themselves most of the time!
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