PIP confusing decision! Furious!

Sammy19897

Cyclamen wrote: »

No practical help here but I really hope they sort this out.

I have been ill since 2009.. I had my PIP changeover late last year and following a fall was in a knee brace which obviously restricted me a fair bit. I told my assessor it was a temporary thing and not part of the reason I was claiming and as i received my claim I assume it was ignored.

So it very much seems to me that something has gone very wrong with your report. I hope its all remedied soon.

Thank you cyclamen, its very confusing and strange, the assessor definitely said to me and my partner that she was basing the assessment before my broken leg, it does leave to believe that it must of been during the decision process the DM looked and gone based it on my broken leg as I had a call from him roughly a week before my decision asking me about my leg whether it was from an accident or something else? as I say to Alice and Muttley I will soon post an update as soon as the PA4 comes through the post, hopefully will have some answers there.

Alice_Holt

Sammy19897 wrote: »

I know full well that I'm definitely entitled to some form of help as these conditions are a constant impact in my life just a shame it has to go down this route.

Totally agree.
If you were on HR DLA mob & MR care, and your conditions haven't improved, then there has been a DWP !!!!-up.
Indeed the broken leg is linked to your pre-existing conditions.
It doesn't make sense.

I'm sure this will be rectified, and if it has to go to tribunal a sensible decision will be made.
But lets hope he DWP put it right themselves.and you don't have to wait to go down this route.

rockingbilly

Sammy19897 wrote: »

I keep hoping that hopefully the DM calls me again like he did previously so I can have a long chat with him to clear this up, I'm not after both higher rates just some support would be appreciated and I know full well that I'm definitely entitled to some form of help as these conditions are a constant impact in my life just a shame it has to go down this route.

From my experience of transferring from DLA to PIP anything is possible where the DWP are involved. I too thought like you - I know full well that I'm definitely entitled to some form of help as these conditions are a constant impact in my life - but you thinking and believing that is no guarantee that the DWP will think the same. By the way I was on High Mobility/Middle Care too.

Sammy19897

Alice_Holt wrote: »

Totally agree.
If you were on HR DLA mob & MR care, and your conditions haven't improved, then there has been a DWP !!!!-up.
Indeed the broken leg is linked to your pre-existing conditions.
It doesn't make sense.

I'm sure this will be rectified, and if it has to go to tribunal a sensible decision will be made.
But lets hope he DWP put it right themselves.and you don't have to wait to go down this route.

Hi Alice,
I got my PA4 through the post and I am more so confused as the assessor did base the length of present conditions on my broken leg, yet despite noting on MSO: 'left leg bending slightly reduced, power in left leg slightly reduced, ability to lift straight left leg reduced, spine can bend forward to reach knee level only, declined mso to right leg due to brace and pain (fractured leg)' so she noted complications that weren't linked to my broken leg but my long term conditions, yet based the length of present conditions on my broken leg... she does quote at the end of the report 'Due to recent and acute nature of condition, a short term review is required to see if symptoms still remain. With complexity of the fracture, its unknown whether her symptoms will improve or deteriorate.... review set for 3 months time guessing that is from date of the assessment. I called them quite angry and said although whats shes written in the report is fairly accurate but its worse so with a broken leg as activities are much more difficult shes based alot of the activities on my broken leg despite her clarifying with me that i was stating this is what it was like before my broken leg for each activity, upon reading the report i remember clearly stating to her that before i broke my leg i could walk up to 50 yards with a break or too but yet shes put i cannot walk further than 20 metres! with comments in regards to my broken leg in almost every activity... i am beyond livid.

Alice_Holt

Sammy19897 wrote: »

Hi Alice,
I got my PA4 through the post and I am more so confused as the assessor did base the length of present conditions on my broken leg,

Which isn't what she told you at the assessment!
Remind me, did you go to the assessment on your own or with someone? If so, perhaps they could document their recollection of that conversation.

It's possible this will go to a tribunal decision.
So, it's a matter of gathering your evidence (and I remember that you did submit evidence with the MR).
Would your GP be supportive?
The How to win your appeal guide I linked to in post 17, has a section on getting medical evidence.
The most helpful evidence directly links your conditions to the PIP activities, points, and descriptors.

I would suggest:
1) Going through the PIP points carefully:
http://www.benefitsandwork.co.uk/personal-independence-payment-pip/pip-points-system

This is also helpful on the interpretation on the points (Pages 86 on, and 97-134)
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/547146/pip-assessment-guide.pdf

2) Identifying where you score the necessary 8 points for an award (12 for enhanced) on both DL and Mob components.

3) Asking your GP (or another healthcare professional) to confirm in writing that your pre-existing conditions meant that you couldn't do these specific activities reliably .
You mentioned in an earlier post that you had proof from "physiotherapists from 2013 stating how long I can stand before my legs buckle and even how far I can walk"; ask the physio / GP to confirm that your condition hasn't improved between 2013 and when you had the assessment.

4) Also get evidence from family / friends which also relate the PIP activities to your pre-existing conditions.
If you were accompanied to the assessment than the note recalling the conversation would be good.

5) Do you have a copy of the DLA form / award letter / DWP confirmation of the award / etc.
That, together with confirmation that there is no improvement to your pre-existing condition would be helpful (and indeed that the broken leg is linked).

It's a case of getting all the relevant evidence together. A tribunal will make a decision on the strength of the evidence before it, so get confirmation from GP / physio that your pre- existing conditions do meet the PIP criteria and won't improve in 9 months.

I do think it's worth checking if there is help available from your local CAB. If a caseworker could take your case on, then they will do most of the legwork (sorry!!) for you. For instance they may be able to write to your GP to obtain medical evidence.

Good luck.

Bananas123

hello sam,

the broken leg is not important really in your case, because it is expected that a broken leg will heal (they guessed 3 months as an average time to heal your broken leg).

they test your joint flexibility for ESA and PIP, again if you have not informed them of physical problems the flexibility section is not really relavant either (unless you have chronic physical problems also, then you should argue them, obviously)

it would be a good idea to get help really from citizens advice or somebody ideally, because although the broken leg doesn't matter towards your claim, the situation and happenings may very well do.

>>>if you broke your leg because of reduced awareness from mental illness, that IS very important<<<

but a broken leg will heal, usually, so not relavant.

---

there's a massive amount that hinges on very small details and sometimes unfortunately you really do need to go get help from someone to help you say the right things.

it's good that you got the report, next step for me was getting a highlighter, finding errors, and then the next step... trying to clearly write them down for the tribunal people.

i think they are trying to transition alot of people away from PIP at the moment..

good luck!

Alice_Holt

If the decision isn't changed at MR stage, this is the form you need to appeal on to the Tribunal Service (TS):
https://formfinder.hmctsformfinder.justice.gov.uk/sscs001-eng.pdf

I would suggest -
Do opt to attend the hearing so that you can explain how your long-term condition affects the PIP criteria - your verbal evidence will be very important.
Don't opt for short notice of the hearing date - gives you time to get any last bits of evidence to the TS / arrange for someone to go with you / etc
You need to attach a copy of the MRN to the SSCS1.

Having completed the SSCS1 form (which lodges the appeal with the TS) you can follow up with evidence, a statement, etc (see http://www.advicenow.org.uk/guides/how-win-pip-appeal).

More info at:
http://www.benefitsandwork.co.uk/personal-independence-payment-pip/pip-appeals
https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/pip/appeals/apply-to-tribunal/

Muttleythefrog

Agree with the Alice advice. There is substantial incompetence in these assessments... but not common I suspect for a HCP to reiterate correctly their technical role and responsibility and then construct a report that fundamentally seems to run counter to their words in technical regard.

Very frustrating. I do think ultimately you'll get joy with this claim... but it may not be at MR stage. I would spell out very clearly (if true) that you consider your broken leg a temporary issue.. a matter upon which you did not base any part of your claim for PIP... a matter that the HCP detailed at assessment was not going to be considered but seems to have featured as key to short longevity of disabilities (prognosis?). Suggest that the HCP has made an error in this regard and encourage a DM to examine that matter and return determinations of disabilities and their requirement for review accordingly to the exclusion of this temporary broken leg. Evidence your long term disabilities and describe them well in relation to the descriptors.

Messy but I do think ultimately you'll prevail. If you can get professional assistance then it may well be worth it.

john2054

i didn't get pip neither. these guys are crooks!

Melissa332

if you are entitled to statutory sick pay then you should be paid for 28 weeks.