TOPIC: Requred level of evidence
Requred level of evidence 5 months 3 weeks ago #236217
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I have submitted my PIP form and attended the medical.
I was awarded higher rate mobility, but nothing for daily living.
However there are numerous issues with the medical. Firstly there were numerous procedural errors (for example I was told the medical was happening at an address that does not even exist!), but despite the various obstacles I struggled and managed to attend the medical.
Then the medical report has major errors - for except for 1 activity, all others have a major error showing the HCP has either ignored submitted medical evidence or has made a false representation of my diagnosed medical issues. In addition the report contradicts itself numerous times.
Then the actual report from the decision maker states he has used the best medical evidence available and makes various conclusions. In my PIP form I requested DWP to contact my GP but I have found out no attempt has been made, and some of the conclusions the DM has drawn could not happen if the DM did have the best medical evidence available, so I consider the DM has falsely represented his assessment.
The DM has not called me to explain his decision so I called up and requested the DM to explain. I was told this was the old procedure for DLA, and for PIP I was allowed to request an explanation but this did not have to come from the DM.
My understanding of my position is that I have submitted evidence in the form of my PIP application form. Then it is up to the DWP to gather evidence to dispute my claim, then the DM should consider all available information to come to their conclusion.
I believe that if the HCP report contains numerous provable substantial errors all the way through (and is potentially fraudulent), it cannot be considered as credible and therefore should be disregarded or cannot be used as evidence against me.
Also by making a provable false declaration on the DM's decision, this is quite likely fraudulent, so my opinion is that a legally valid decision has not yet been made by the DWP.
When I received the phone call to explain, I was told that evidence submitted in my PIP application form and evidence from my GP confirming diagnoses was not sufficient, and I required medical evidence specifically showing how my medical conditions were specifically applicable to the PIP descriptors. I will find this impossible to fully prove as one of my medical specialists has stated they will only reply to the DWP, not on my request, and I should be under the care of a few more specialists but due to many NHS failures I am not.
In addition, the person did not agree that a medical report with substainal errors all the way through should not be considered as credible evidence. As the medicals are not audio/video recorded, it is impossible to prove many of the things I believe to be wrong. However a particular point I will note is that the HCP was a physiotherapist who has made a page full of detailed measurements and observations of my muscular skeletal system. I am baffled how such accurate measurements can be provided when not a single measurement was taken during my medical. Also this report contains a false statement about one of my problems which I can prove with measurements. Considering I am able to prove a false declaration in the HCP's area of specific expertise, I believe the substantially undermines the entire report.
However I was told that if I can prove the report to be wrong in areas, that particular element of the report may be disregarded, but the rest of the report is to be considered as valid evidence that takes precedence over the evidence I have provided in the format of my PIP application form.
The person went through questions I had for a few activities, but then I suspect the person got fed up of such a long phone call and being put in awkward positions so the phone call was terminated before I had explanations of all the activities, and no further phone call was received.
So my main questions:
How much weight is carried by my declaration of limitations in my PIP application form?
If it is impossible for me to gather medical evidence proving how my medical conditions restrict me with respect to the PIP descriptors, what weight should be given to medical evidence of confirmed diagnoses?
If I can prove the HCP report to contain numerous substantial errors, should any of the report be considered valid evidence against me?
If I can prove the HCP report to be fraudulent (by making knowingly false representations), is it fair to conclude that the report should be totally disregarded?
If I can prove the DM's report to be fraudulent (by making knowingly false representations), should I be then submitting an MR, or should I be arguing that a legally valid decision has not yet been made, and this needs to be made before I consider whether to make an MR?
Requred level of evidence 5 months 3 weeks ago #236222
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Hi AVM Survivor.
This question is impossible to answer. Clearly as far as the DWP are concerned you did not show sufficiently how your limitations impact on your daily life regards to the specific PIP criteria. You need to go back and examine where you lost points and see if failed to make appropriate use of the reliability criteria or the need for your limitations to be present on the majority of days to be considered.
I don't know whether you tried to access any of your medical records from the hospital or the GP, but if you did so this might give you the evidence you need. It is your legal right to make a Subject Access Request (SAR) for your G.P. records under The Data Protection Act 1998. (DPA 1998) You simply make the request at your G.P. Practice reception, there will be a form that you need to sign, and there will probably be a charge
You can only refute the claims in your report through the mandatory consideration process. At the moment that report is the one that stands.
It is entirely up to you what you want to say - but I would suggest that you don't use the word fraudulent. You are better to stick to pointing out the errors. The decision will only be changed if you address the specific PIP issues where you believe you should have scored points and you didn't.
A decision has been made and it one that you disagree with, but you will not get anywhere accusing them of being fraudulent. If you want to challenge it you need to go through the MR process.
If you decide to go for an MR, your greatest focus needs to be on where you think you meet the criteria and didn't rather than criticizing the assessor because you believe they wrote a fraudulent report.
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