If There’s Criteria How Does This Happen?

Margaret_Skinner

I applied for PIP last August - missed an assessment through illness in November and was allowed to continue with my application. Attended an assessment in June of this year and was turned down for payment. I noticed I was only 2 points short for daily living so decided to open a Mandatory Reconsideration which I did, citing my views on some of the points given and explaining why I disagreed (mainly related to the fact that when you have chronic fatigue, there is never acknowledgement that tasks cannot be done regularly and safely).

I got another letter saying the decision was the same - did I want to appeal? And I almost stopped there because I’ve already been through an appeal for ESA in February and wasn’t sure I could face the stress involved in another one. However after a lot of thought, I decided to continue so made an online appeal and was waiting for a date for Tribunal.

Last Monday I received a voicemail from the DWP asking me to phone them - they had had another look at my case, didn’t agree with the decision made and wanted to make me an award, thereby saving me going to Tribunal. I thought I was dreaming!

Sure enough though - when I phoned next day, the nicest man ever asked me some questions, awarded me the necessary points to make a standard rate award for daily living AND mobility and basically left me on Cloud Nine. I actually burst into tears when I came off the phone, the relief was so great!

But I don’t understand how this can happen. I get how points are awarded on criteria but how can one employee override another with exactly the same information in front of them? At first I thought it was someone from the Tribunal place but he definitely said he was from the DWP.

calcotti

Anecdotally there has been an increase in cases where this happens. Glad you have been spared the anxiety of, and long wait for, a tribunal.

The decisions are made by Decision Makers, although there is a system individual judgement is required.

The initial decision is made by one DM. At MR stage a different decision maker looks at it again - in practice historically this seems to have been very superficial. In your case a third DM has looked at it and has come to a different decision to the previous two.

Alice_Holt

Margaret_Skinner wrote: »

...how can one DWP employee override another with exactly the same information in front of them?

I would put it down to the poor (and consequently inconsistent) quality of DWP decision making.
Remember that at appeal 74% pf PIP appeals are allowed - and that is after two DWP DM's have looked at the claim.
That is a very large number of flawed assessments and DWP decisions.
(And many flawed decisions won't even be appealed to the tribunal service - as you almost didn't)
https://www.parliament.uk/business/committees/committees-a-z/commons-select/work-and-pensions-committee/pip-esa-assessments-forum-17-19/?page=147
https://www.theguardian.com/society/2013/feb/08/dwp-fitness-to-work-fiasco


Why is DWP decision making poor? It could be workload, inexperienced DWP employees, inadequate training, politics, a target driven culture to reduce the welfare bill, it could be many things.
In my view the nature of the assessments - with so little weight often attached to the claimants own health professional - GP's, etc - doesn't help.
Frequently because the claimant "appeared calm, and maintained eye contact" at the assessment (according to the assessor), this is sufficient for the DWP decision maker to overturn a previous PIP award, and ignore many years of medical evidence showing the claimant suffering from depression, anxiety, and poor mental health.

The outcome is distressed claimants, increased food bank usage, huge waits for appeals, costs transferred onto both HM Courts and Tribunal Service, and voluntary charities like Citizens Advice from the DWP.
I would suggest you pose your question to your MP.



As you are now in receipt of both ESA and PIP I would suggest a benefits check to see if any additional disability premiums are payable.
https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/pip/before-claiming/extra-help-pip-entitles-you-to/

calcotti

Alice_Holt wrote: »

.

The outcome is distressed claimants, increased food bank usage, huge waits for appeals, costs transferred onto both HM Courts and Tribunal Service, and voluntary charities like Citizens Advice from the DWP.

In cooection with see https://www.judiciary.uk/wp-content/uploads/2019/10/6.5845_The-Senior-President-of-Tribunals-Annual-Report-2019_Print_NoCrops.pdf#6.5845_The%20Senior%20President%20of%20Tribunals%20Annual%20Report%202019_Print.indd%3A.87043%3A1117 pages 25 to 32

Appeals against decisions of the Department for Work and Pensions have increased rapidly this year although figures are not yet available for the complete period.
The trend in our intake in recent years saw receipts reach a peak of 507,000 in 2012-13 followed by a sharp decrease to 112,000 in 2014-15. The trend to 2018 was up again, increasing from 157,000 in 2016, to 228,000 in 2017 and 238,000 in 2018. In response to this we have increased our clearances rate from 190,000 cases in 2017 to 214,000 in 2018.
Although the rapid rise in appeal numbers has outstripped our ability to recruit and train sufficient numbers of panel members to keep pace with increased receipts, in recent years we have worked closely with the Her Majesty’s Courts and Tribunals Service (HMCTS) and the Judicial Appointments Commission (JAC) to secure large scale recruitment exercises across Tribunal member types and in the past year been able to deploy a considerable number of new members across the jurisdiction. We have appointed a total of 130 fee-paid judges, 225 medically qualified members, and 125 disability qualified members during the course of the last year. We have also worked flexibly across the First-tier, assigning 58 fee-paid judges and eight disability qualified members

TELLIT01

Decision Makers are human, and interpretation of the level of incapacity in many cases is subjective. If all aspects were absolutely clearly definable there would be no need for human involvement, the decisions could all be made by computer.
In this specific instance the OP was only 2 point away from having entitlement to an award so there was a high possibility that further scrutiny might lead to a different decision. It is just as likely that the third person to review the claim decided that, although they agree with the original decision, there was a good possibility that a decision in favour of the claimant would be made at Tribunal. That being the case it is 'easier' simply to permit the award without Tribunal intervention.

Margaret_Skinner

calcotti wrote: »

Anecdotally there has been an increase in cases where this happens. Glad you have been spared the anxiety of, and long wait for, a tribunal.

The decisions are made by Decision Makers, although there is a system individual judgement is required.

The initial decision is made by one DM. At MR stage a different decision maker looks at it again - in practice historically this seems to have been very superficial. In your case a third DM has looked at it and has come to a different decision to the previous two.

Sounds like I was pretty lucky then! And I would agree that at the MR stage it very rarely comes back with a different decision from the original one - at least in my experience.

Margaret_Skinner

Alice_Holt wrote: »

I would put it down to the poor (and consequently inconsistent) quality of DWP decision making.
Remember that at appeal 74% pf PIP appeals are allowed - and that is after two DWP DM's have looked at the claim.
That is a very large number of flawed assessments and DWP decisions.
(And many flawed decisions won't even be appealed to the tribunal service - as you almost didn't)
https://www.parliament.uk/business/committees/committees-a-z/commons-select/work-and-pensions-committee/pip-esa-assessments-forum-17-19/?page=147
https://www.theguardian.com/society/2013/feb/08/dwp-fitness-to-work-fiasco


Why is DWP decision making poor? It could be workload, inexperienced DWP employees, inadequate training, politics, a target driven culture to reduce the welfare bill, it could be many things.
In my view the nature of the assessments - with so little weight often attached to the claimants own health professional - GP's, etc - doesn't help.
Frequently because the claimant "appeared calm, and maintained eye contact" at the assessment (according to the assessor), this is sufficient for the DWP decision maker to overturn a previous PIP award, and ignore many years of medical evidence showing the claimant suffering from depression, anxiety, and poor mental health.

The outcome is distressed claimants, increased food bank usage, huge waits for appeals, costs transferred onto both HM Courts and Tribunal Service, and voluntary charities like Citizens Advice from the DWP.
I would suggest you pose your question to your MP.
As you are now in receipt of both ESA and PIP I would suggest a benefits check to see if any additional disability premiums are payable.
https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/pip/before-claiming/extra-help-pip-entitles-you-to/

That’s a good idea asking my MP - I hadn’t thought of that. I would agree the quality of assessments need to change bigtime - it totally does seem that if you get there and answer the questions you’re basically doomed! But the costs incurred in what’s involved when all these assessments result in being turned down and then the subsequent appeals must be massive so it makes no sense.

And funnily enough I got a form for additional disability premiums through the post today - I had never even heard of this one!

Margaret_Skinner

calcotti wrote: »

In cooection with see https://www.judiciary.uk/wp-content/uploads/2019/10/6.5845_The-Senior-President-of-Tribunals-Annual-Report-2019_Print_NoCrops.pdf#6.5845_The%20Senior%20President%20of%20Tribunals%20Annual%20Report%202019_Print.indd%3A.87043%3A1117 pages 25 to 32

Appeals against decisions of the Department for Work and Pensions have increased rapidly this year although figures are not yet available for the complete period.
The trend in our intake in recent years saw receipts reach a peak of 507,000 in 2012-13 followed by a sharp decrease to 112,000 in 2014-15. The trend to 2018 was up again, increasing from 157,000 in 2016, to 228,000 in 2017 and 238,000 in 2018. In response to this we have increased our clearances rate from 190,000 cases in 2017 to 214,000 in 2018.
Although the rapid rise in appeal numbers has outstripped our ability to recruit and train sufficient numbers of panel members to keep pace with increased receipts, in recent years we have worked closely with the Her Majesty’s Courts and Tribunals Service (HMCTS) and the Judicial Appointments Commission (JAC) to secure large scale recruitment exercises across Tribunal member types and in the past year been able to deploy a considerable number of new members across the jurisdiction. We have appointed a total of 130 fee-paid judges, 225 medically qualified members, and 125 disability qualified members during the course of the last year. We have also worked flexibly across the First-tier, assigning 58 fee-paid judges and eight disability qualified members

But surely if they increased training and recruitment of Decision Makers or the way assessments are carried then they wouldn’t have to increase all these people for Tribunals because there wouldn’t be so many?

Margaret_Skinner

TELLIT01 wrote: »

Decision Makers are human, and interpretation of the level of incapacity in many cases is subjective. If all aspects were absolutely clearly definable there would be no need for human involvement, the decisions could all be made by computer.
In this specific instance the OP was only 2 point away from having entitlement to an award so there was a high possibility that further scrutiny might lead to a different decision. It is just as likely that the third person to review the claim decided that, although they agree with the original decision, there was a good possibility that a decision in favour of the claimant would be made at Tribunal. That being the case it is 'easier' simply to permit the award without Tribunal intervention.

I agree with this to a degree - I think the fact there were only two points in it for the daily living component made it slightly more viable than if I had scored very low initially - but the Decision Maker could easily have stopped at that whereas he went on to ask about mobility so that I got an extra 4 points there as well. He kept saying “I really don’t know why this wasn’t picked up earlier” as though he felt the same decision should have been arrived at earlier in the process.

It just freaks me out slightly that people’s lives can change so drastically depending on who looks at your case but like you say, they’re all human!

calcotti

Margaret_Skinner wrote: »

But surely if they increased training and recruitment of Decision Makers or the way assessments are carried then they wouldn’t have to increase all these people for Tribunals because there wouldn’t be so many?

Absolutely but they do of course fall into different budgets. The DWP employ and train Decision Makers whereas the Ministry of Justice funds the tribunal service. In the past tribunal judges have suggested that the DWP should be charged by the MoJ because of the poor quality of DWP decision making and the poor quality of evidence they provide, which it has been suggested would be unacceptable in any other court.

It would undoubtedly be cheaper overall if the DWP were better at making the initial decisions and/or correcting errors at MR stage - quite apart from the fact it would reduce stress caused to claimants.

TELLIT01

When I was working at DWP, far from increasing the number of Decision Makers, many were moved to other roles. Often it was those with most experience who were moved too. Not only did that obviously increase the workload on those remaining, but as they were predominantly less experienced they would be far more likely simply to accept the information from the assessor in order to hit their own throughput targets.
I can't speak for other departments, but my experience within DWP was that hitting targets wasn't simply the most important thing, it was the only thing that was measured and given any importance.
The section I worked on had the target for claims processed almost doubled in the time I was there. When I said it was not possible to do all the necessary checking to ensure correct payment in the time allowed, I was told accuracy wasn't our problem as another section would have to correct any errors.