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shambles of a PIP ATOS assessment and decision

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5 years 4 months ago #220951 by rog747
good evening
I have been a supporter and reader for some years of B&W and always found it useful and encouraging - I do need some input now please

Sad to report a shambles of a situation of my best friend in London with his DLA to PIP F2F assessment and decision just received from DWP.
He had asked for a home visit but was refused but asseseo said at the interview he should have really been considered for one.
He is 61 and has been a DLA lifetime recipient (awarded on DS1500 rules) many years ago with both care and mobility at Higher rates.
He was an ILF client but now receives a good Social services direct payments care package for employing his 2 PA's.

He has AIDS (long term survivor 1983) with many HIV and long term HIV drug related side effects including faecal incontinence and urgency, peripheral neuropathy, memory loss and function,
atrial fibrillation, urology complications with a failed prostate operation now causing urgency and urinary incontinence. Fatigue, anxiety, panic attacks, unable to process or read simple bills or correspondance plus now has a torn knee - his is in constant pain tired and unable to manage his medications - He cannot walk more than 20m
I can go on and on as you can imagine -

despite sending in the all his consultant's and GP's up to date notes plus his latest Care Plan (a total of 40 pages) the ATOS assessor was unspeakablly cold and hid behind her screen- she had no empathy of his complex long term and worsening conditions
DWP nor ATOS had not contacted his medical professionals.
the assessor would not listen to us and we had to reiterate to her that she understood what his complex needs were - English was not her first language and my friend was in severe difficulties and under duress at the F2F - he attended with his carer

We knew the assessment was appallingly done and now his PIP claim has just arrived having been awarded NO mobility and only basic rate for help at home - thus we are speechless

we do know the next step is to at once call for the decision to be looked at again with a view to a M-R and also for the assessors report to be sent to us - His HIV consultant is appalled and wants to do all she can

Is there anything else you can suggest - please?

why are they not taking note of his care plan showing a serious need for help both in and out of the home (done by a social worker) and his latest medical notes which run to 3 pages ?

I can see this going to appeal frankly but just maybe someone in the DWP a DM can see sense immediately and get his benefits awarded correctly.

I have seen on your forum and in the press recently a large spike in horror stories like this

thanks

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5 years 4 months ago #220961 by Gordon
Rog

Welcome to the forum, you might want to have a look at the following FAQ which explains where everything is

Welcome to Benefits and Work

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.

Your primary task is to show that you meet the criteria, there are many reasons you 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 I walked 50m, I did but they have failed to document that I 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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5 years 4 months ago #220984 by Orangeblossom
Replied by Orangeblossom on topic shambles of a PIP ATOS assessment and decision
Could this poor man possibly qualify under the terminal illness rules if his HIV consultant filled in a form, do a new claim perhaps?

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5 years 4 months ago #220990 by rog747
Thanks - we are requesting today by phone the assessor's report and also asking for the decision to be reviewed (the MR) on the grounds of errors, wrong assumptions and supposition and omissions -
taking on board care not to be argumentative nor appear hostile (although the assessor was at the F2F lol) but asking the DWP DM to have the decisions looked at again constructively with our replies to the reports with a review for them to be overturned.

Both requests to be followed up by sending letters (thanks for the templates and PIP appeal guide links)

I trust that this is enough for now ?
nb:
Should we add in any further Dr or Consultants letters of support (asking to review the case) at this stage? His Consultant is most supportive.

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5 years 4 months ago #221005 by Gordon
Rog

He should also consider making a formal complaint to the Assessment Provider about the report.

ATOS (IAS) complaints
www.mypipassessment.co.uk/feedback/#unha...ment-experience-1552

Capita Complaints
www.capita-pip.co.uk/en/complaints.html

ATOS (IAS)
www.mypipassessment.co.uk/feedback/

If you can supply the reports within a reasonable timescale then you should, notify the DWP that you are doing so and they should allow 28 days for this to happen.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
The following user(s) said Thank You: rog747

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5 years 4 months ago #221017 by rog747
Cheers as always G.

We called this afternoon for a copy of the F2F report and its on its way - the lady (very nice) also asked if we wanted to commence the MR - we said yes and stated we will follow up this with a letter and supporting evidence etc
A text message has already come saying the MR process has been confirmed.

Here is a Template of the letter we intend to send - what do you think please?

To: DWP PIP Decision Maker/Case Manager
Dear Sirs,

MANDATORY RECONSIDERATION REQUEST

Further to my telephone call on 09/11/2018 requesting same.
I do ask please that you can kindly reconsider your decision dated 31/10/2018.

I consider that I have provided the DWP with enough evidence (both oral and written) for a decision to be made that I am clearly entitled to an ''ongoing'' award of PIP at the Enhanced rates for both components of daily living and with mobility (help with getting around).
I do not consider that the Decision Maker took full account of the severity and worsening of my conditions or of the way that it affects my everyday activities and bodily functions both at both at home and going outdoors and getting around.
Plus the review has not fully taken into account the help that I need and receive to undertake those daily functions.
That I note the review PIP award is only until 24 June 2020 whereby here the DWP is under the impression that my conditions will significantly improve - My situation and my conditions will not at all likely improve, and I therefore ask the DWP DM/CM to consider granting an ongoing or an indefinite period award please.

I do wish to add the following evidence:
A supporting letter from my Consultant Dr xxxx, and please note my replies/responses to the incorrect and erroneous case points given on the original assessment.

NB:
Please do bear in mind when contacting me:
I have great difficulty in understanding both the review, the assessment, and the decision making process and I will always need the help
of my PA/Carer and/or a friend to help explain to me any such situations, outcomes, and discussions whether it be face to face, or on the telephone and/or in writing.
In addition,
Should I wish to withdraw this decision review request I will only do so in writing. Under no circumstances will I withdraw this request verbally. If you speak to me on the telephone about this matter, nothing I say should be construed as a withdrawal unless and until it is confirmed in writing by myself.

I look forward to hearing from you forthwith, I trust with a corrected and revised decision.
Thank you.
Yours faithfully,

Gordon - the B&W guides, forums and templates are invaluable and I hope that we can kick this one into the grass - Please let me know your feelings on the template letter
Thanks
Rog
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