PIP claim denied

MinnieMouse123

Hi everyone,

I received a letter to say my PIP claim has been denied.

I called the PIP people and they said I need to write a letter and provide evidence from my G.P by the 26th of November. My issues are all related to mental health, physically I have no issues but my mental health issues are such that I can only work part time. I used to claim DLA and when I had that, I could survive financially, now I am up the creek without a paddle.

Has anyone else with mental health issues had a positive experience with claiming PIP?

I'm currently writing the letter and trying to explain how my mental health issues affect me day to day but I'm afraid of not explaining myself properly. When I went for my assessment I thought I was very clear about what was happening but perhaps I wasn't and that's why my PIP was denied.

Does anyone have any advice please? I would appreciate it.

Thank you.

w06

Sorry you've been turned down

Have you checked against the 'descriptors' link to descriptors to see where you think you should have scored 'points'

Does the letter explain why you didn't in more detail?

Alice_Holt

Useful online resources:
https://www.rethink.org/living-with-mental-illness/money-issues-benefits-employment/personal-independence-payment
http://www.advicenow.org.uk/guides/how-win-pip-appeal
http://www.benefitsandwork.co.uk/images/image/samples/dla/sample_pip_jan17_v24.pdf
https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/pip/appeals/mandatory-reconsideration/
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/655612/pip-assessment-guide-part-2-assessment-criteria.pdf

You may wish to get help from your local CAB / advice agency on the PIP appeal process
https://www.citizensadvice.org.uk/about-us/contact-us/

Here is a MR template:
https://www.leicester.gov.uk/media/178163/mandatory-reconsideration-request.pdf

Good luck

MinnieMouse123

Thank you for your reply w06.

They said I had no difficulties with physical issues, which is true and I don't dispute.

They also said "The evidence shows you no functional restrictions preventing you from completing all aspects of daily living, planning, and following journeys and moving around safely, repeatedly, reliably and to an acceptable standard and within a reasonable time frame period, unaided, most of the time. This is consistent with informal observations at your face to face consultation, the evidence available at your face to face consultation, how you engaged with the assessor, the available evidence, the information you provided about how your disability affects you and your mental state examination results. I cannot consider any help you need not covered by the activities for daily living and mobility, including lack of income."

I told the assessor(who was a trainee)that I am suicidal on a regular basis and self harm as a way of coping with life. I told him that I had self harmed that morning because I was freaking about having to get to the venue, which was several miles from home and I had to use public transport to get there. I was a nervous wreck during the assessment, crying when I told him about how I manage with my part time job. I don't know if he even wrote about that in his report as there was no direct mention of any of that in my letter.

As for the descriptors, I would be ineligible for the mobility component, but I should be eligible for the daily living component because I:

Cannot cook a simple meal using a conventional cooker but is able to do so using a microwave. (2)

Supervision, prompting or assistance to be able to manage medication or monitor a health condition (1)

Needs prompting to be able to engage with other people. (2)

Needs prompting or assistance to be able to make complex budgeting decisions. (2)

Needs prompting to be able to undertake any journey to avoid overwhelming psychological
distress to the claimant. (4)

That 11 points I should be eligible for.

MinnieMouse123

Thank you Alice.

I didn't realise there was a form to send. They just said write a letter.

w06

The last 4 of your self-assessed points are actually for the mobility descriptor and so by your assessment you wouldn't gain an award because you'd have 7 for the daily living part and 4 for mobility. (you need 8 for standard rate of either)

If you feel sure that you should have gained those points then you need in your request for reconsideration outline why you think those descriptors apply to you.

FBaby

Cannot cook a simple meal using a conventional cooker but is able to do so using a microwave. (2)

Supervision, prompting or assistance to be able to manage medication or monitor a health condition (1)

Needs prompting to be able to engage with other people. (2)

Needs prompting or assistance to be able to make complex budgeting decisions. (2)

Needs prompting to be able to undertake any journey to avoid overwhelming psychological
distress to the claimant. (4)

Did you evidence any of this? They cannot just go by you saying 'I can't do that'.

Why can't you use a conventional cooker? What happens if you're not prompted to take medication, take journeys, make complex budgeting decision. Who does this for you and in which form? Do you show any clinical letters confirming the above?

Alice_Holt

Penitent wrote: »

Things I wish I'd known when I first applied:

Don't just read the descriptors, make sure you understand what they actually mean and what kind of level of function they're supposed to cover. Read the regulations connected to the descriptors and check to see if any of the terms used are defined in the regulations (for example, "engage socially" doesn't just mean "talk to someone", it has a specific meaning that goes beyond this). This will save you arguing over points you were never going to get.

Make sure you understand about variability and reliability (good overview here).

Keep your MR/appeal requests as clear and to the point as possible--the DMs and Judges don't seem keen on slogging through a load of fluff (trust me, I am the God of Fluff and I made it all the way to the Upper Tribunal before someone was willing to read it properly ). Use headings for each descriptor.

Include evidence and refer to it in your MR/request. Number the paragraphs on your doctor's letters so you can point directly to the relevant piece of information. Quote it if it's short so they don't need to flick back and forth.

"I need support to do a because of b symptoms (see paragraph c of letter d). These symptoms occur on e number of days each week. As I need support to do this/can do it less than 50% of the time/cannot do it safely/etc., I believe I meet criteria f."

Excellent advice. OP - Please, please take on board penitent's post.

Particularly about making MR / appeal submissions clear, concise, and to the point.
The starting point (IMO) is the descriptors you believe should have been awarded. Have a brief paragraph on each explaining clearly and (if possible) with examples why this applies to you, citing relevant medical evidence if possible.

IMO having sight of the assessment when writing the MR can be a mixed advantage.
I understand it can be very upsetting and the urge to refute untruths may seem very urgent , but please don't launch into a long angry / rambling critique of the medical assessment and the HCP.
Rather use the report to identify internal inconsistencies and logical failures of the HCP, and build on any points awarded. So, for instance, if 2 points have been awarded for needing prompting to cook because of depression and none for taking nutrition / washing / dressing etc- then, if it applies, it is perfectly reasonable to argue that, and detail how, the depression also causes difficulties with those activities as well.

One advantage of getting advice from your local advice agency is that they should understand how the descriptors should be applied (see the PIP assessment guide link in my earlier post), and can cast a dispassionate eye over the report.

Above all, think how best to communicate the relevant points to the DM / tribunal panel. Communication happens only when the recipient understands clearly and completely the points made by the sender.
Concise, clear, relevant and vivid (examples) is the best way to go. Backed up if possible by medical evidence.