Has benefit been underpaid?

Mensi

A very close relative of mine has was recently transferred to PIP from DLA, which was finalised within the last three months. She previously received DLA at medium for care component and low for mobility but was reassessed to the higher component for both. The assessment was done based on confirmation with her doctor, care coordinator, and so on. She has severe mental health problems, and she has been receiving DLA from either 2013 or earlier, I can't remember, but definitely not after 2013. What I would like to know is why they have only moved her to the higher bracket only with the move to PIP, shouldn't she have been in the higher bands for both from the very first day she was awarded DLA? Her condition has remained the same from day one that she started receiving DLA. She was diagnosed with Schizophrenia. Shouldn't they be backdating the higher rates back to when they first started paying DLA?



Would a claim for backdating be successful in this instance?

NeilCr

The time to challenge DLA was when she was first assessed and given her award. I am afraid she will not be able to apply for backdating now.

PIP and DLA are different benefits and "bands" do change - both up and down.

Mensi

Considering DLA and other benefits organisations routinely make mistakes, isn't it likely they did the same here? It is clearly evident from the her condition that they got the assessment wrong. Shouldn't she (or a person on their behalf since she is incapable of making the claim for herself) contact PIP to try to get this backdated? Some people accept decisions made by these benefit teams without querying it at the time and it is only, later on, they question it, and in some cases rightly so.


You are correct DLA and PIP are different, but isn't PIP replacing DLA? In time, DLA is being phased out altogether.

calcotti

Yes PIP and DLA are different and PIP is replacing DLA. The PIP decision now does not prove the DLA decision was wrong. Even if the DLA decision was wrong it cannot be challenged retrospectively, there are time limits for challengingbenefits and these have long passed for a decision made 5 (or more) years ago.

kingfisherblue

DLA is being phased out for working age adults, but remains for children. It is not a direct replacement, and has different criteria. The increased payment is only payable from the time of the decision - you could have challenged the DLA decision if you felt it was incorrect at the time, but instead you accepted it. That does not now give you grounds to try to appeal the original DLA decision in the hope that you can get a backdated amount. It is possible (and likely) that the DLA decision was correct, based on DLA critieria, and that the PIP decision is also correct, based on the different criteria for what is a different benefit. PIP is not a direct replacement for DLA. Mant people receive lower wards on PIP, but I did read somewhere (I can't remember where) that PIP is more likely to take into account mental health issues and learning disabilities. Maybe that is the reason for a higher award.

Mensi

Not a like-for-like replacement? I see. But still, I guess there is no harm in trying. Do we appeal to PIP since they have now taken over?


I find it difficult to believe how circumstances that were the same was deemed not serious enough to be worthy of the higher grading. It smacks of incompetence on the part of DLA. How can a person with severe mental health problems have only gotten medium for care component? Ridiculous.

NeilCr

Mensi wrote: »

Not a like-for-like replacement? I see. But still, I guess there is no harm in trying. Do we appeal to PIP since they have now taken over?


I find it difficult to believe how circumstances that were the same was deemed not serious enough to be worthy of the higher grading. It smacks of incompetence on the part of DLA. How can a person with severe mental health problems have only gotten medium for care component? Ridiculous.

Then it should have be been appealed at the time of the initial award. Or was it and the appeal turned down? Have you spoken to whoever filled the DLA form in in the first place?

I am sorry but there is nowhere you can go now to challenge the DLA award. Calcotti and kingfisherblue have explained the situation well.

kingfisherblue

Mensi wrote: »

Not a like-for-like replacement? I see. But still, I guess there is no harm in trying. Do we appeal to PIP since they have now taken over?


I find it difficult to believe how circumstances that were the same was deemed not serious enough to be worthy of the higher grading. It smacks of incompetence on the part of DLA. How can a person with severe mental health problems have only gotten medium for care component? Ridiculous.

No, you are too late to appeal. It was not necessarily incompetence, it was just that the criteria has changed. To give you one example, a person with a severe learning disability, but able to walk, was only awarded low rate mobility on DLA, even if they could never go out alone, or find their way to a nearby, familiar place. With PIP, they would be likely to receive enhanced mobility because the learning disability and safety of the person are now considered. It's not incompetence, just different criteria.



If you are hoping for a large payout from the DWP, I think that you are going to be disappointed. There was a time to appeal, but nobody did. That time has now passed. Instead, maybe you should be focussing on the fact that PIP has awarded your wife enhanced, which is appropriate for her current circumstances, and takes into account the criteria for the current benefit.

Alice_Holt

Mensi wrote: »

But still, I guess there is no harm in trying. Do we appeal to PIP since they have now taken over?

There is a 13 month time limit to appeal a social security decision.

http://www.cpag.org.uk/content/appeal-rights-and-mandatory-reconsideration
"Since 2013, where a claimant wishes to challenge a refusal of benefit, there has been a requirement to apply for a revision (referred to as a ‘mandatory reconsideration’) before appealing to the First-tier Tribunal. Under the Social Security and Child Support (Decisions and Appeals) Regulations 1999, SI No.991 (‘the 1999 regulations’), a claimant is entitled to request a revision within a month of the decision on ‘any grounds’ and a late application for revision can be accepted by the DWP within 13 months of the decision."

NeilCr, Calcotti, and kingfisherblue are correct. There is no right of appeal for the previous DLA award.
You are wasting your time. You would be better helping your very close relative get a benefit check to ensure maximisation of her current income.

Mensi

Mobility I can understand, the criteria was clearly different then. But it is ridiculous that she wasn't awarded the higher rate for the care component. If they refuse to hear me on this do I have a right of appeal or see a citizens advice group?

poppy12345

Mensi wrote: »

Mobility I can understand, the criteria was clearly different then. But it is ridiculous that she wasn't awarded the higher rate for the care component. If they refuse to hear me on this do I have a right of appeal or see a citizens advice group?

No, you do not have any rights to any appeal for the DLA decision as it's past 13 months. If you didn't agree with the decision at the time then you should have appealed it then. DLA no longer exists as it's now PIP.



As they have now been awarded Enhanced rate for both parts of PIP i have no idea why you would want to appeal the decision because there's nothing to appeal.As has been said, DLA and PIP have different criteria and are totally different benefits.