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TOPIC: Inconsistent ESA and PIP awards

Inconsistent ESA and PIP awards 1 week 4 days ago #241273

My partner had just been reassessed for ESA in the support group and was successful so is continuing to receive ESA in the support group. At the same time he went through the process of moving from DLA to PIP. On DLA he had the higher rate for care and for mobility and has now received a PIP assessment where all he is awarded is the standard rate for care and nothing for mobility. These two results (ESA and PIP) seem inconsistent to us, (not to mention the PIP decision is flat out inaccurate and wrong). We are wondering if we should use the ESA outcome as part of the appeal against the PIP decision. Has anyone else any experience of such an inconsistent outcome and/or using this as part of an appeal, please?

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Inconsistent ESA and PIP awards 1 week 4 days ago #241279

Hi Ali

The 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, the PIP area also has 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.

You need to make sure that whatever is included is relevant to the PIP criteria and you need to say why it is, the way DLA was awarded is different from how PIP is.

PIP was engineered to be a more difficult to award than DLA, many DLA claimants will receive vastly reduced awards or even no award at all on transfer.

DLA looks at generic care needs in regard to bodily functions, PIP looks at the claimants specific ability to carry out an activity such as eating. DLA was awarded because the claimant needed an amount of care (in time) during the day, the night of both, to help them with that bodily function. PIP looks at the claimant's ability to complete specific tasks within the activity and is points-based, these are clearly defined and it is easy not to score points because the claimant has not shown that they meet those specific criteria.

DLA treated the use of aids as a reason to reduce the amount of care needed, PIP treats aids as an indication of disability and in general they score extra points.

DLA's care need was reasonably generic, PIP treats prompting, assistance and supervision as different activities and as a result, they can score different points.

DLA required that the care was required for the majority of the time, for PIP it is the majority of days.

For PIP activities must be completed reliably, this means

• Safely – in a fashion that is unlikely to cause harm to themselves or to another person.
• To a necessary and appropriate standard – given the nature of the activity.
• Repeatedly – as often as is reasonably required.
• In a timely manner – in a reasonable time period.

Although DLA considers these terms, they are poorly defined as they are implemented through Case Law rather than being defined in the legislation as they are for PIP.

Referring to any more recent evidence you have is more useful. In regards to the mobility part of your question.

The Going Out activity looks at three things.

Planning a route - this is primarily a cognitive or sensory (e.g. blindness) activity. You are being asked about the problems you would have with working out how to get from one place to another, you do not need to be able to follow the route that you are planning.

Undertaking a Journey - this is to do with mental health issues such as agoraphobia and social anxiety and is concerned with you leaving the house to go somewhere, they will be interested in the things that stop you doing this. You need to show that you would suffer "overwhelming psychological distress" to meet the criteria.

Following a route - This activity about the problems you would have navigating a route. So, are there any problems; cognitive, sensory or mental health issues that would prevent you from doing this? This is different from undertaking a journey, in fact, if you cannot undertake a journey then you will not score points for following one and vice versa.

In answer to your question ESA and PIP descriptors, there is a slight overlap on a few questions. I would use our guides as mentioned above to help answer PIP questions. The guides are well written and sets out to answer most of your questions, if there are any questions that are unanswered then do come back to the forum and post your question.

Gary

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