UK: PIP appeals - advice, recommendations?

This is very useful @Simbindi.

My friend, with ME was given Zero points and assessed as being able to make complex budgeting decisions, based on the question. If you buy a loaf of bread costing 75p and hand over £1, how much change would you get?
She asked if she could write it down, allowed. she then answered 35p, but corrected herself quite quickly!

At her appeal her award was upgraded to maximum on the ?self-care section. this was due to the judge accepting that ther were errors and misinterpretations in other areas. She also acknowledged that the 'bar' for complex budgeting decisions and the equivalent for rareading were very low indeed.

 

I thought I'd put up a link to a (very long) thread that I made about my PIP stuff 6 years ago on the Benefits and Work website.

I believe that it's available to anyone - you have to be a Member to post or reply to posts, but I think anyone can see the thread.

Sorry it's so long, but it was written over months! I've no idea if it might prove helpful, I felt I got some helpful suggestions.

 

Hi all,

got a potentially confusing one, seems a bit niche so thought I'd ask around around if anyone had any knowledge / experience.

I've applied for 2 different UK disability benefits, both of which ultimately come from the DWP (Department for Work & Pensions), but which have to be applied for separately.

The first is the Universal Credit "Limited Capability for Work & Related Activity" group, which was eventually successful.
I had an in-person health assessment with a DWP nurse, who made the decision that I should be put in the LCWRA group.
This is good, I get a bit of extra cash in the Universal Credit, and can also earn a bit more before they start tapering off the Universal Credit.

The second is PIP (Personal Independence Payments).
I'm at the 3rd stage now
(stage 1 = initial application (rejected),
stage 2 = Mandatory Reconsideration (rejected),
stage 3 = Appeal)

I've submitted my appeal, at the appeal stage all the info & paperwork gets sent to an independent tribunal, and then a "hearing" is booked,
where (I think) the 3 parties (me, the independent tribunal, the representatives of the DWP), all get together (maybe on the phone rather than in person),
and the independent tribunal make a final decision.

What I've noticed looking through all the paperwork that gets sent to all 3 parties, is that the DWP nurse who did my in-person assessment for Universal Credit considers me very disabled / entitled to money (entitled to UC LCWRA specifically)
but the PIP assessor who did my telephone assessment for PIP considers me basically not disabled at all / not entitled to any PIP.

That in itself is kind of whatever, I wouldn't expect them to always be the same, and it's different people doing the different assessments etc, but I'm wondering if anyone knows / has any experience of whether
it's possible that if the tribunal ultimately agrees with the PIP assessor that I shouldn't get any PIP, the DWP could retroactively void / overturn the UC nurse's assessment and undo my entitlement to Universal Credit LCWRA.
I hope that makes sense. It seems unlikely, but yea it's a very complicated system....

Any experience much appreciated!

Thanks

 

My advice would be to join (subscribe) to the website www.benefitsandwork.co.uk

It costs £20 a yr but is worth 10 times that in my experience.

They have a forum which is moderated by people who are trained to know about the different benefits, the advice there is top notch & has helped me massively.

If you were on ESA i could have said more but now that has been subsumed into UC i am very confused by it all.

Your concern about whether its possible if the tribunal decide against you for PIP they could look again at your UC. I'm afraid they could, yes. But it depends, being put in the Limited Capability for Work Related Activity Group is based on your having fulfilled certain specific criteria, & depending on which criteria you were judged to make it into the LCWRA group under, will make the difference. Because the criteria are different. Edited to add: But if you get yourself clued up & preferably, get some help/support too, then you should in therory be able to use the UC assessors report to challenge the PIP one. Its a tricky situation i hope you can access some support. Do you have any lined up - eg Citizens Advice bureau? Perhaps your local www.lawcentres.org.uk could help you? an appeal is a big deal to tackle alone.

How many points were you given for PIP in the Daily living & Mobility Categories? Have you got yourself a copy of the assessors report?

I am sure if you ask the question in the forum on B&W website, linked to above, & read their guides to both, & guide to appeals (a marathon in itself) you'll be better equipped. They are absolutely first rate.

Good luck with it, its a nightmare system i feel for you

 

I second the recommendation of Benefits & Work, both the guides and the forum.

If you want to join but are really short of cash, join their free fortnightly email list—which is useful anyway, as it always contains a handful of interesting news summaries and isn't padded out with irrelevant fluff. Most times the email offers a discount code for membership, which gives you up to a fiver off. Scroll down to just above the black box at the foot of this page to opt in:

https://www.benefitsandwork.co.uk/news

It's interesting that the nurse who actually saw you in person considered you had significantly limited capability, but the person who only spoke on the phone didn't—this should be brought up at tribunal. But it would be impossible to challenge the decision maker's conclusions fully without the assessor's report.

The process is to go through the report, identify every inaccuracy that led to a loss of points, and note down the line you'll take to challenge it. Then, of course, double-check that none of these contradict anything you said in your original application. (I'm sure you know this already, but the tribunal can only look at what that application said; you can't introduce any new evidence unless you make a fresh PIP claim.)

Where the B&W forums can help is in choosing how to approach individual points, if you're not sure which line of argument to take for the best. It's all-nigh impossible for an ME patient to know every piece of relevant case law, but some of the folk on there know it well. There are occasions where previous rulings will strengthen an argument, or even provide you with one that hadn't occurred to you.

Good luck.

 

Thanks @Kitty and @JemPD ! I have signed up to Benefitsndwork.co.uk and put the same question to the forum there.
I actually do have the assessor's reports (both the UC nurse and the PIP telephone assessor), as I've been sent the whole bundle of documents ahead of the hearing (no hearing date booked yet). The part you say about identifying inaccuracies and challenging them - I've actually done that already, that was part of the process of submitting my appeal - I went through each of the PIP descriptors and noted how many points the assessor had awarded, and why I think that's inaccurate, and how many points I think would be accurate.

So all of that is in the bundle already...

Is what you're saying that I can / will do that process again, but in real-time, verbally, during the appeal hearing?

 

In PIP I was awarded 2 points for Daily Living, and 4 for Mobility.
I'm "arguing" for 23 points for Daily Living, and 8 for Mobility...

I have the UC Nurse assessor's report and the PIP Telephone assessor's report, yes!

 

No, not at all. I've no knowledge of actual hearings, only of helping someone prepare for one by doing what you're already done. B&W contributors may be able to help you through the tribunal prep and understanding what will happen on the day.

I guess it's still possible that the judge and/or DWP could decide the issue ahead of time, so that no hearing needs to take place? This is what happened for the person I was helping out; they made a thorough rebuttal of the assessor's recommendations and DWP decided to offer an increased award rather than proceed to tribunal, as it would probably have been clear to the judge that the decision-maker ought to have awarded more points. This is probably the best outcome of all (as long as you get the points you were arguing for), as it's so much less stressful.

As for your question about whether an unsuccessful lower tier tribunal could undermine your UC award—as @JemPD says, yes they could decide to look at it again, but as you don't yet know the tribunal outcome, I would try to defer that worry as much as humanly possible! The descriptors are different anyway, so it certainly wouldn't be a foregone conclusion.

 

I'd missed that detail in your original post Joseph. And while it is certainly still possible for them to mess with your UC if your PIP doesnt go well, personally i'd be less worried about that happening knowing that detail. It will be pretty hard for them to argue that the person who only spoke to you on the phone, was able to have more/better information than the nurse who actually met you & observed you.

If the appeal doesnt go your way (and to be honest i'd think it was reasonable to hope it will go your way -i mean those very low points are daft unless you're only mildly affected), but if it doesnt & they do start trying to mess with your UC, then make sure you keep highlighting that the nurse who actually SAW you & was able to observe you made those decisions... because using a phone assessment to over-ride the results of an observed one, would be absurd. Not saying it couldnt happen but i'd have thought they would find it hard, so even i, an inveterate worrier, wouldnt be too worried about that. Like @Kitty says - defer than concern for now, one step at a time.

But yes just do what B&W say, i have such respect for them, they help people and are so ethical too.

 

Hi @Kitty and @JemPD , thanks for your reassuring messages!

Yea I suppose I'm trying to weigh up and potential risks - if there's a possibility that going through with the appeal might mean that I lose the UC LCWRA then I might be tempted to "quit while I'm ahead" as it were...

But it sounds like while possible, the probability is very low, and in fact more likely to work the other way around (the UC assessor's report gives more weight to a higher PIP award)..

 

@josepdelafuente.

So sorry you’re having to deal with all this, can only make it more difficult to manage your illness.

I would strongly advise that you do not attempt your appeal without professional advice.

First stop is CAB they have a whole department for benefits. Call asap, waits for appointments can be long.

Call MEA & Action for ME. Generally they are no longer much help due to cuts to their advice departments, but you gotta ask. This is because they may be able to tell you stuff about services or DWP trends in your area. Also online or by phone you can buy for very little money (£1?) both of their guides to following the process and what to expect. You need these.

There maybe other ME/CI charities in your area who could provide info.

Then phone around and or search online for any local disability advice centres in your region, they know lots and are the best of resources, which is why most of them have been defunded into or close to closure. But if you find one with a benefits advisor that is exactly what you need. Expect a wait list here too.

Also as @JemPD says sometimes there are law centres these are meant to be your best option (though I don’t personally know anyone who has used one) but again, you’d have to get lucky with your location and their availability.

The process is designed such that no individual certainly not a sick one is likely to be able to succeed without some professional assistance. That is not to say that a few people don’t muddle through ok, and tribunal is your best chance for an understanding reception.

Best of luck with it all.

 

Thanks @Ash , I'll call my local CAB first thing tomorrow morning!

Then maybe I'll try the others depending on how that goes. I don't have a hearing date booked yet, and the online portal says it could be months before a hearing is booked..

 

Excellent, plenty of time.
Finding help is a time consuming process and a higher energy activity. So more time ahead to enable you to pace yourself assimilate information and ensure you get on waiting lists for an appointment or call back, the better.

I think it’s right to prioritise CAB They do tend to know the general process very well. Exactly how helpful they can be may depend on the person allocated to handle your case, and how familiar or otherwise they are with ME/LC. So good to get advice from elsewhere if possible as extra back up.



I would strongly advise you keep a diary in a designated notebook or ring binder of names, phone numbers/web stuff, openings times etc so that you can follow up as and when energy permits without wasting energy on re dos or lost information. It can very monotonous leading to extra difficulty remembering etc. It’s portable and the battery won’t die on you.

 

The other thing about having help is that if you do it all on your own they may use that against you - they may make the argument that if you can manage this on your own then you cant be as ill as you say you are - we all know perfectly well that you will make yourself iller & have to sacrifice other more necessary activities to manage it, but they can be like that.

If you do end up appearing at tribunal alone, make sure you point out that although you are there alone, you have had to (for example obviously swap out for your own true experience) 'because i've had to prepare these documents I have had to sacrifice my own personal care in order to have the energy, & its taken me ______ wks. Otherwise they may wrongly assume you just did it on your own with minimal problems.

 

Yea, that's exactly why I've just got on with everything by myself so far!

Aha yea ok, I am already in touch with Action For ME for some other stuff, as far as I can tell from a quick scan of their website, they wouldn't be able to assign me a support worker / case worker (not sure what they would be called?) at the moment, but maybe worth emailing them anyway. Although I am currently waiting for a confirmed diagnosis of ME (actually one of the things I'm in touch with Action For ME about!), so the fact I still don't have that (just a number of other diagnoses), possibly would rule me out of being able to access that kind of help from Action For ME anyway..

The ME Association website doesn't seem to say anything specific about case workers / support workers for disability applications etc, but again maybe worth me calling them anyway..

Good plan!

Thanks all for all the help, advice & suggestions!

 

Ah yes the DWP have deployed that strategy already once, the PIP telephone assessor cited the fact that I was able to do the 45m telephone assessment as "evidence" that I don't have any cognitive issues... I mean.. we all know all the reasons why it's total bullshit so no need for me to go into that one here!

Yes, good point, thanks. I have been trying to remember to make that point in general - in the in-person UC LCWRA assessment I explained to the nurse that travelling to the assessment centre and doing the assessment would affect my functioning & capacity for the rest of the day, and probably longer, and that basically doing any one thing (preparing a meal, doing some work etc) means not doing other things..

But yes good to keep making that point.

 

A quick update - thanks so much for all the advice & encouragement, CAB advised me to contact an organization called Z2K (https://z2k.org/),
I've just spoken to them and they are going to assign me a support worker / case worker etc etc.
They reassured me that it's incredibly unlikely / bordering on impossible that the PIP appeal could lead to the UC LCWRA being overturned, so that's good.
So next step is for me to scan the bundle and email it over to them, and then get the support worker person set up as an official representative with HMCTS etc.

I almost definitely wouldn't have spent the time trying to find a representative if you guys hadn't encouraged me, so thanks again @Ash @Kitty @JemPD !

 

Fantastic to have that reassurance, good luck with the appeal!

 

That's really good news, @josepdelafuente, and should be a huge help. Just having someone on your side is immensely reassuring, even if in the event they don't have to do a great deal. I hope it goes well!

 

That's fantastic @josepdelafuente very best of luck with it