PIP and worsening of condition

Ms_Wheels

Hello everyone,

I am looking for some advice regarding a second PIP claim whilst there is currently a MR in process.

Brief background info:
My friend has fluctuating physical and mental health conditions and had been on enhanced rate for care and mobility. Her PIP was recently reviewed after she reported some improvement in her mobility during 'good' periods and she lost her entire PIP award. At this point, she asked for my support with the MR - we are currently awaiting the outcome.

My friend's physical condition varies greatly and at the time of the PIP review she was not aware of rules regarding fluctuating conditions and we addressed this in the MR. At the time of the assessment she was walking unaided (sometimes using a stick). At other times she is wheelchair bound and unable to get out of bed unaided. In recent weeks, she is going through a bad period and she has been confined to her bed or wheelchair (when she has support to transfer from bed).

My friend wanted PIP to know she is currently in a bad period and we spoke about the possibility of submitting further evidence to support the MR. Before we could met, my friend phoned PIP and they have started a new PIP claim. The form arrived last and she wants my support to return it asap.

Advice/information required:
I have completed MR before (including my own), but I have never come across a situation where a new claim has been started whilst the MR is still going through. I would have thought it more sensible to add further information to existing MR, but now they have issued new PIP forms I don't think we can go back.

Has anyone had experience of this?

Can someone point me to DWP guidelines on this situation?

Would the new claim be automatically linked to the MR/previous claim?

Would the new claim be subject to 3 month qualifying period? (I hope not as she has had this condition for years and this is not the first time she has been this bad. The main difference is that thing time my friend is being encouraged to accept home care/support to ease the pressure off of her family).

Any other information you can provide will be gratefully receive.

Thank you

poppy12345

She reported her condition had improved, which lead to the re-assessment and then her PIP was stopped because of this. Reporting changes when you're having a few of your better days may not be the best idea. PIP is about how you're affected at least 50% of the over a 12 month period.



She's now claiming her condition has got worse and now the 3 month rule may apply. It will be difficult to argue with the because it will seem like she's contradicting herself.



It's never a good idea to start a new claim while waiting for the MR because the 2 claims won't be linked. I'd advise a visit to her local CAB or the likes for advice here.

Ms_Wheels

Thank you Poppy.

I advised my friend to seek advice from CAB.

Alice_Holt

Ms_Wheels wrote: »

I advised my friend to seek advice from CAB.

Yes. I'd let her be guided by an advice agency / CAB. She has created a very complicated situation for herself, though misunderstanding how PIP operates.

IMO she would be better advised to continue with the appeal, and not put in a new application. She probably does not want to further compound her situation by applying again. It is very likely any new application so soon after a failed re-assessment will result in the same decision as that re-assessment (I have seen the DWP link successive assessments).
She really doesn't want to get into the situation of having then to appeal multiple failed assessments. (A successful appeal of the first decision would only run to the date she reapplied, and another DWP decision was made).

Expect the MR won't change the decision in her favour, and she will need to proceed to appeal. Currently due to appeal volumes there will, unfortunately, be a long wait for her tribunal hearing She certainly needs help with her appeal, from an agency who understand PIP and the appeal process.

She can start by keeping a dairy of her fluctuating conditions and her ability to reliably perform the PIP activities, so she can demonstrate to a tribunal how she is affected on the majority of days (i.e more than 50% of days over a year).

PS. Since she currently has no award - there is no penalty I can see in not completing the PIP2 form,

Ms_Wheels

Thank you Alice. I agree, my friend is now in a very complicated situation due to misunderstanding of PIP rules around fluctuating conditions. I wished she had spoken with me before contacting them in the first place, but unfortunately we cannot turn back time.

The advice given by CAB is to proceed with the new claim. They checked various pieces of information and confirmed this is the correct procedure. This has also been doubled-checked with DWP.

The MR will continue and DWP have suggested that with their average waiting time it could still be another 6-8 weeks before we hear anything. They have advised if the MR comes back and my friend is happy with the outcome, we can cancel the new claim. It was my understanding that once a new claim is submitted, that any MR and/or appeal will only cover the date up to the new claim (for my friend this gap is approx 6 weeks). When DWP advised we could withdraw the new claim if the MR is successful, I queried it and they confirmed this was possible.

However, as you have said, often the MR does not overturn the original decision and then there is the option of an appeal.

To support the new claim, as well as any appeal, I have asked her to keep a diary and also collect evidence from carers/social services, OT, physio etc.

If we do need to appeal either the original claim or the new one, CAB have advised to return to them and have given us a reference number.

Thank you Alice and Poppy for your time and advice, it is much appreciated.

justaquestion

Best of luck helping your friend.

It has to be remembered that with people with mental health problems, some have total illusional ideas of their health and capabilities, and even when they think they are feeling better and maybe even capable of work all this is simply a symptom of their condition.

Unfortunately there is no way that the DWP can ascertain and reach a decision on this and simply take the reporting of the change of circumstances at face value.

Muttleythefrog

justaquestion wrote: »

Best of luck helping your friend.

It has to be remembered that with people with mental health problems, some have total illusional ideas of their health and capabilities, and even when they think they are feeling better and maybe even capable of work all this is simply a symptom of their condition.

Unfortunately there is no way that the DWP can ascertain and reach a decision on this and simply take the reporting of the change of circumstances at face value.

Agree with all above advice... good luck assisting.

Just quoting this (bolded) because early in the days of ESA there was even the extreme case of a claimant who refused to accept there was anything wrong with them... and duly had a face to face WCA assessment which concluded similar... much to the dismay of the psychiatrists treating them who now had a patient armed with a healthcare report giving them a 'clean bill of health'.

Unfortunately the system seems poorly geared up (PIP and ESA) to detect what may be poor insight into conditions of the claimant - be that in relation to implication of greater or lesser disability.

Alice_Holt

Ms_Wheels wrote: »

It was my understanding that once a new claim is submitted, that any MR and/or appeal will only cover the date up to the new claim (for my friend this gap is approx 6 weeks). When DWP advised we could withdraw the new claim if the MR is successful, I queried it and they confirmed this was possible.

Thanks. That's interesting, and (dare I say) surprisingly sensible for the DWP.
I hope it goes well for your friend. I would be interested to know the eventual outcome.

Regards.

Ms_Wheels

Thank you for the comments about mental health and benefit claims. My friend's mental health condition was dismissed outright by the assessor despite medical evidence.
It's amazing how quickly the assessor can 'cure' someone

Alice_Holt wrote: »

Thanks. That's interesting, and (dare I say) surprisingly sensible for the DWP.
I hope it goes well for your friend. I would be interested to know the eventual outcome.

I was surprised too Alice. I actually found the DWP employee very helpful. That said, because I am somewhat cautious of information DWP give me (having previously experienced their inconsistent advice), I always make a written record of the phone call and confirm my understanding back to them and I can refer to it if we have any problems at a later date.

I'll report back once we know the eventual outcome.

Thank you all once again.