PIP confusing decision! Furious!

Sammy19897

Hello all I'm new to these forums and just need to rant while also seeking supportive views from others.
just quickly add some info about myself before I go into any detail, well my name is Samantha but prefer to be called Sam, I'm a 27 year old female who works as a part-time cashier and enjoy photography and editing in my spare time. But I also battle everyday with long-term disability and this has limited my life in many ways not just work. I suffer with Joint Hypermobility, Spinal stenosis, degenerative joint disease and mental health issues.
I was originally in receipt of DLA high mobility and middle care before the move to PIP.
I completed my application and sent it off.
Now here's where it gets confusing 7th January 2017 I severely broke my leg, tib, fib and femur around my knee practically shattered. this required metal work some left to heal alone, surgery was performed 11th January 2017. I was invited to an assessment with ATOS 27th February 2017 which I attended despite requesting a home visit, I travelled there and the journey was very painful, each bump or knock is enough to have me scream in pain, I had to attend in a wheelchair as I cannot manage weight baring on my good leg for long. I had my assessment with a fairly nice lady, she made it clear that we were discussing what I could do before I broke my leg. she saw when I lifted my other leg the spasms due to weakness from the spinal stenosis and degeneration and even saw all my hypermobile joints.
About a week following the assessment I had a phone call from the decision maker as to whether my break was from accident or something else, I stated it was from an accident and gave him details of the hospital I attended.
A week 15th march 2017 following that phone call I received the decision letter in the post....
the decision letter dated 7.03.2017 stated that I scored 13 daily living therefore I cannot be awarded, scored 12 mobility therefore I cannot be awarded, they believe that my condition will improve in 3 months, yes they are probably right when considering my broken leg and neglecting everything else just find it funny how they mention my medical history is consistent... very annoyed and frustrated, I put in for Mandatory Reconsideration 17.03.2017 unsure of what to write as I couldn't list category's I wrote something I'm not sure is appropriate they received it and were scanning it onto the system 21.03.2017 so now I'm just stuck here stewing in anger and frustration. I will copy and paste my letter to them in the comments below, I'm so confused and frustrated and panicking as I'm not sure what to do, 31.03.2017 if I'm not better by this time it would be my works 12 week sick policy therefore I would lose my only source of income, I keep getting reoccurring fevers and my balance is almost non existent same as my strength, I'm losing faith just hope I don't have to wait long to hear, please feel free to leave your opinions.

Sammy19897

To whom it may concern,

RE: Mandatory Reconsideration Notice.

I am writing to you to appeal against the decision dated 7.03.2017 of my PIP claim dated 12.12.2016. The decision I find is very contradictive and confusing, as it was made clear to me by the assessor’s questions of the medical assessment on 27.02.2017 that the assessment was based on what I could do before my broken leg (7.01.2017 date I fractured my leg), with my mental health, spinal stenosis and joint hypermobility, and even was examined on my other leg and upper body. Despite the obvious restrictions and limitations, it’s apparent to me that attention was drawn to my broken leg during the decision process and I believe this has been used to measure the length of time to improve my disability, which I feel is unjustified and I can’t help but feel penalised. As stated in the decision my medical history has been consistent, as has my conditions since childhood gradually worsened. My spinal stenosis causes me severe pain when standing and it’s unlikely I will undergo surgery due to success being doubtful and as I have Joint hypermobility in my back I may continue to dislodge discs causing more deterioration as explained to me by orthopaedic surgeon, despite this my mental health has to be considered also. My joint hypermobility is a possible reason as to why the break in my knee was so severe. Throughout my body I have hypermobile joints (loose, weak), this includes my back, ankles and knees which to my understanding is a contributing factor as to why I have a !!!!!!! gait and issues controlling my balance. On top the spinal stenosis cutting out my nerves causing severe pain, I cannot be comfortable in the standing or sitting position for long and often need to change position. My conditions will still be with me in January 2018 just like they have been majority of my life. My attendance at work has been reducing since before the fracture around November 2016 and I even had to reduce the amount of hours I do, due to the decline in both physical and mental health. These conditions be it my mental or physical will continue to impact my life and I’m losing faith in myself. I would appreciate you taking the time to reconsider the mobility and care components award length based on my long term conditions that I addressed in my claim form, which were the conditions I was medically assessed for, not my broken leg. Please could you review all information and evidence I enclosed with my claim form of my long term health conditions these include, an MRI report dated 19.06.2013, Physiotherapists (*********) report dated 1.10.2013, GP medical report dated 22.12.2016, along with those I enclosed copies of prescribed medicines and sick notes for support at work. I am going to enclose additional copies of the same reports to avoid there misplacement. Please feel free to contact me if anymore information is needed.

Kind Regards

Miss Samantha *********

nannytone_2

if you are entitled to statutory sick pay then you should be paid for 28 weeks.
if you aren't then you need to put in a claim for ESA when your work gives you SSP1 form

kingfisherblue

For PIP, twelve points means that you will be awarded enhanced rates, so if you have 13 for daily living and 12 for mobility, then you should be on enhanced. Are you saying that you have the points but have been told that you have not been awarded anything?

kingfisherblue

nannytone wrote: »

if you are entitled to statutory sick pay then you should be paid for 28 weeks.
if you aren't then you need to put in a claim for ESA when your work gives you SSP1 form

OP stated that this is for PIP.

NeilCr

Sorry I'm a bit confused. You say you scored 13 Daily Living and 12 Mobility

You need 12 points for Enhanced on both Living and Mobility

From a PIP POV as you have sent in an MR you have to wait for the result and then appeal if you are still unhappy with the decision. You have 30 days from the date of the decision letter - it might well be worth getting help with the appeal from CAB or similar. I

Edit. Cross posted with Kingfisher!

Sammy19897

king fisher Yeh because they are considering the decision timeframe based on my broken leg not my long term conditions, basically they feel I'm going to be better in 3 months in some ways they are right if they base it on my broken leg and ignore my long-term conditions

Sammy19897

Hi Neil, same I'm so confused hopefully MR comes through positive till then just stewing.

NeilCr

Right.

So they are saying that you would have got Enhanced but, because you don't meet the "before and after eligibility criteria"

https://www.gov.uk/pip/eligibility

you won't get it.

Did they say what points you would have scored without the broken leg?

If the MR is negative I'd suggest getting help from CAB or similar with the appeal. Be aware of the 30 day time limit

Some 65% of MR decisions are overturned at appeal

What about other benefits? Do you rent? Will you be eligible for Housing Benefit and Council Tax Support for example.

Nannytone is right about ESA. It sounds like your company sick pay (which likely is more than SSP) is for three months. You should then go on to SSP

Sammy19897

NeilCr I requested for someone to contact me to explain the decision but the request was deleted off the system. I was made aware by assessor that they were judging it on what I can do before the broken leg, when I put my application in it was before I even broke my leg its very frustrating as I even has proof from physiotherapists from 2013 stating how long I can stand before my legs buckle and even how far I can walk.... I will be going to court if they turn down the MR no doubt about it.

nannytone_2

kingfisherblue wrote: »

OP stated that this is for PIP.

they also say that they only get 12 weeks sick pay from work and this is currently the only source of income