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Subject Access Request Findings unsure whether to complain during MR

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1 day 8 hours ago #311330 by Wednesdays Child
2023 I was awarded PIP for MH till Jan 2026- review forms/assessment decision was between July and September 2025. I went from Standard on both rates to only 4 points on DL- 2 for complex financial and 2 for engaging with people. The decision maker only refers to the PA4 as to what they used to make the decision- and that I wouldn't have realised there was a change in circumstances that meant I wouldn't have known was relevant. The decision letter mentions nothing about my medical evidence- I supplied reports from my ADHD clinician (confirming diagnosis and medication treatment which increased from 2022 and 2023), a private psychiatrist report from June 2025 (asking my GP to change my long term anti-depressants, give me sleeping tablets and to seek ADHD coaching), I did include a discharge letter from CMHT and that I was awaiting CBT from 2023- just to show I had been under them. The assessment was over 2 hrs 40 mins, it was recorded and I've been sent a copy. The PA4 was internally audited by Ingeus and when I received the copy it reads like two different people wrote the descriptor justifications part- the reasons to award 4 points are transferrable to some other activities. The history section for example clearly talks about my working from home part time, and only has to attend 4 in person meetings per year- but then later on in the travel section- talk about my commute to work as if its daily. So I requested a SAR as I wanted to see what version of the PA4 did not make it to the decision maker.

When I got the bundle- I was shocked to find time stamped records of my claim on the PIP computer system that show that it was only a 10 minute period from my PA4 task being allocated to someone from work queue to them ending my claim. The PA4 was twenty something pages, the AR1 form was something like 40 with the medical evidence, and they had to do some admin tasks like a ID verification, write up a decision letter, upload the superseded descriptors etc. Clearly they couldn't have properly reviewed my whole claim and evidence and do all the admin tasks in 10 mins. There is also some admin errors like entering my completely wrong health conditions into the superseded descriptor section, my health professionals listed are from previous claim not current, I have a vulnerability marker- but got not telephone call about the decision. I am also confused why I was referred to Ingeus without a Case manager reviewing my forms and evidence in the first place - I was being treated as paper based review and the notes are not clear the reasons why it went to a full assessment. Ingeus haven't shared the multiple versions of my PA3 and PA4 despite following it up when I got the bundle. I telephoned PIP enquiry line and spoke to a CM in Wales who confirmed that it does read like they only spent 10 mins on my review.

I made a verbal MR request when I got the SAR bundle - it was 243 pages- so its taken me longer than a month to write up a really extensive response where I have listed errors and contradictions that Ingeus did as well as challenge each descriptor I was either not awarded points on or lower than I felt was fair. There is a major weakness in relation to their understanding of MH/Neurodiversity and cognitive impairments/ fluctuation- they literally wrote that because I am medicated that I should be fine. I specifically did not use the phrase complaint in my MR response- as I didn't want to annoy the DM doing the MR. Text Messages say that I should get the decision of my MR by end of January.

I'd really appreciate some external views on what is a reasonable time to review someones claim/review. I'm scared to raise a complaint as it will show on the system and the MR DM will see it, but I am absolutely beside myself with anticipation and anxiety about this, the last 3 months have really really triggered me to the point I can't think about anything else.

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1 day 3 hours ago #311336 by BIS
Hi Wednesdays Child

I'm sorry to hear of the situation you are in. I'm not surprised that you are stressed by it.

It's up to you what you decide to do, but a separate team deals with complaints, and sometimes people have found it useful because it has forced one of the assessment services to repeat an assessment. (Of course for some people that would be too much).

I don't think ten minutes is sufficient time to review someone's claim, but it's not me you have to convince. I can't tell you how long I think it should take because it would depend on the amount and quality of the evidence both on the form and any additional attached information.

I hope that they stick to what they said and you get a positive response in January.

BIS

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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