PIP advisor lied re. Assessment. How can we get justice?

Tanny08

Thankyou

And thanks to everyone that’s replied it’s really helped

Alice_Holt

OP,

Can you look at my post @8. Does your sister have warning of her seizures? Can she make herself safe before a seizure?

I have indicated which PIP descriptors you might include on the MR below, but it would really be helpful if you could respond to my posts.

As Spoonie Turtle says it looks like you would benefit from more knowledge of PIP activities and descriptors.
Have you read the PIP assessment guide (now linked to by 3 posters), and what points do you feel your sister should have scored?

Have you read the How to win a PIP appeal guide? This is essential reading. Do you have any questions about the appeal process?

Does your sister have an advice charity locally she could access with family assistance?



Your Q's:

1) Should she have been assessed by a doctor?

No, any suitably trained HCP employed by the assessing company can carry out an assessment

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/831261/PIP-assessment-guide-part-3-health-professional-performance.pdf
Sections 3.1 to 3.3.

(You may want to read section 3.8 as well)

2) As my sister has a high grade brain tumour, should she have been assessed at all? There are rules around these kinds of illnesses

If you are referring to the PIP exceptional rules, here is some info about these claims;
https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/pip/help-with-your-claim/how-to-claim-if-terminally-ill/



I would second ST's words:
"I understand the desire for justice, but the only real way is to focus on fighting for an appropriate award for your sister. Any upheld complaint against the assessor is a bonus in terms of justice, but it won't actually help your sister be awarded the money she is entitled to. So you need to be thinking of these as two separate objectives - first to fight for the correct award, and second to make the complaint in order to hold the assessor to account."


PIP descriptors you might include on the MR
From your post @9.
"Medication is prepared in a dossett box, by family members and she is reminded when to take it."
3b . Needs any one or more of the following –
(i) to use an aid or appliance to be able to manage medication;
(ii) supervision, prompting or assistance to be able to manage medication.
1 point.

"On a good day, my sister can get into the shower to wash. Even during this time she is supervised due to risk of seizures."
4c. Needs supervision or prompting to be able to wash or bathe. 2 points.

"She is right handed so food has to be cut up, and eaten with the left hand. She has special light cups in case of dropping a cup that’s too heavy."
2b. Needs –
(i) to use an aid or appliance to be able to take nutrition; or
(ii) supervision to be able to take nutrition; or
(iii) assistance to be able to cut up food.
2 points.

That gives 5 points. 8 are needed for a standard award.

Preparing & Cooking a meal?
You haven't mentioned this PIP activity.
If the seizures come without warning then this may apply:
1e. Needs supervision or assistance to either prepare or cook a simple meal. 4 points.

I would imagine your sister needs aids such as a perching stool, electric can opener, adapted kettle, etc, so at a minimum:
b. Needs to use an aid or appliance to be able to either prepare or cook a simple meal. 2 points.

Dressing and Undressing?
You haven't mentioned this PIP activity.
Does she require physical help to dress most days, does she need aids (see PIP assessment guide or the Benefits and Work guide for what constitutes an aid)?
Would she take more twice as long to dress as someone without a disability? If so then she cannot do this activity reliably and should score points for this activity.

Reliability is a very important concept in PIP, encompassing safely, to an acceptable standard, and within a reasonable timescale. The PIP assessment guide and the Benefits and Work guide will both give you more information on this.

Going back to my earlier post @8 -
How about engaging face to face?
You write she "is confused and very dysphasic (to the point where she cannot form words)" . Does this apply for the majority of the time (over a 12 month period)? "
If so, then it is additional evidence that social support may be needed:
9c. Needs social support to be able to engage with other people. 4 points.

You write "Sister requires taking to all appointments", this is covered by the Mobility component for which your sister has been awarded the enhanced award. For the Daily Living award, you are looking at help required with the face to face appointment (see my post @8).

How about household budgeting (per my post @8)?
How is this affected by her cognitive deficits?
Does this apply?
10b. Needs prompting or assistance to be able to make complex budgeting decisions. 2 points.
(For the difference between complex and simple budgeting see the PIP assessment guide or the Benefits and Work guide.)

Totting these up (if they all apply) now gets us to more than 12 points and an enhanced DL award.

I've posted this overlong reply because I feel that you're approaching the MR / appeal from the wrong perspective.
For the MR / appeal you really need to start with the PIP activities / descriptors.
Then explain why (taking into account the vital factors of majority of the time, reliability, and severity of risk) these apply to your sister. Illustrate, with examples, how her conditions mean she needs assistance / aids for these activities.

Evidence attached to the MR can come from family members who supply the assistance. E.g. a letter detailing the help given to your sister (with regard to the PIP activities) and why this is needed. Enclose any recent medical / OT letters / etc you have readily to hand.

Who completed the PIP2 form?
Did it identify the problems your sister had with these PIP activities?
Did you keep a copy?
It really helps to be consistent throughout the claim / appeal process. Hopefully there is nothing you will be writing in the MR that wasn't covered in the PIP2.?

freddie2

I also informed the assessor that I would be contacting CAPITA to write a formal complaint, and asked for her PIN number as I would also be contacting the NMC. She refused to give me her PIN number, reluctantly provided her name and I believe this may have influenced her inaccurate report.


There is no need for a nurse to give you their PIN ( and they are discouraged from doing so by the NMC). You only need their name if you wish to engage with the NMC about their conduct.

poppy12345

Tanny08 wrote: »

In a nutshell, the assessment had found that my sister does not need any help or supervision the majority of the time.

We will write to request a mandatory reconsideration and explain that the report was flawed and that it was conducted in an illegal fashion. For example, the assessor asking how my sister is when she has not had a seizure, when she has frequent seizures, is not a fair representation.

That will not help your sisters PIP claim. You've been given really good advice by a few knowledgeable people and doing this could harm your sisters case. You need to put that aside for the MR/Tribunal. Make the complaint a separate thing.



I also feel that you're not understanding the descriptors and what they mean. What about this link https://www.gov.uk/government/publications/personal-independence-payment-assessment-guide-for-assessment-providers/pip-assessment-guide-part-2-the-assessment-criteria


Have you at least read it? It's been posted a few times throughout the thread.



Please answer Alice's questions.

Alice_Holt

poppy12345 wrote: »

"it was conducted in an illegal fashion"

That will not help your sisters PIP claim.

Quite.

An MR needs to show clearly why and how the descriptors apply.
Referencing any supporting medical evidence included with the PIP2 form, and additional evidence supplied with the MR (i.e letters from carers).
A clear grasp of the PIP activities, descriptors, and points is needed.

There is scope for casting doubt on the credibility of the assessment report at the next stage of the appeal process, when a submission to the tribunal is prepared. At this point the claimant and their representative will have a copy of the DWP evidence bundle.
Any internal inconsistencies within the assessment / evidence bundle can be highlighted, Together with (if relevant) an explanation of why the claimant might have been / felt unable to give full answers to the HCP.

I'm not sure the OP realises that the decision is made by a DWP decision maker who should also be guided by the PIP2 report.

Given that posters have repeatedly explained the importance of separating the MR / appeal from the HCP complaint, it is unfortunate that the OP in her last post re-stated "We will write to request a mandatory reconsideration and explain that the report was.... conducted in an illegal fashion."

I now think her sister will be best served by getting help with her appeal from an advice agency / benefits caseworker. I do hope her family can help her do this, as it will give her the best chance of getting a DL award.

The OP can then concentrate her efforts on the complaint, free from the danger of comprising her sister's appeal by conflating the two.

[Deleted User]

I have ASD and a number of physical health problems, my assessor turned up early and refused initially to leave saying they could turn up early if they wanted to. My support worker hadn't turned up (I don't do well with conversation). So I became very stressed. The assessment didnt' go well, the assessor wasn't exactly rude but made it as difficult and challenging as she could. When she asked me to do squats I was in disbelief lol (I have arthritis quite badly). Her report was full of lies, stating things had happened that hadn't.

But unfortunately, if you get someone that is doing the job because it allows them to be unpleasant, this is hardly unusual. There are ethical assessors around, my son had one (he is quite incapacitated by his problems), but there are also the other sort.

Get a copy of the report the assessor made asap. It will help you write your MR and Tribunal Request. Don't get too heated about what the assessor says.

In my comments I did as suggested here, explained why I did meet relevant criteria, explained how the initial doorstep challenge set the scene for the whole of the assessment (stressed me out) and indicated a lack of knowledge of ASD, and therefore answers weren't probed properly or asked as reported while I was highly stressed. Other than that, for exercises she said I'd done that I wasn't even asked to do I said the assessor seems to have made a mistake - rather than she lied and used evidence to back up why these exercises could not have produced the assessor stated result.

No change was made at MR stage (in fact the DWP added the fact I had picked up both my dogs, one a full sized GSD for goodness sake).

At Tribunal, they listened, asked quite a few probing and unexpected questions, I reached a point where I couldn't give clear answers anymore and thought I'd completely mucked it up but was awarded enhanced care and mobility. I'm afraid at that point and that point only, you have a chance of justice. But 75% of cases that go to tribunal end with decisions in the client's favour.

But I agree, its worth making a complaint about the assessor, but don't do it on the phone, do it formally. But don't expect the result you want, I'm afraid any DWP led things seem to be biased against the client. Sorry to be so cynical.

I totally understand your outrage and shock at how the assessment was carried out, but you have to rise above that and stick to the facts as to why your sister meets the criteria, and carefully question the assessors report. Say she didn't understand the condition and so this is why she questioned in a certain way rather than get personal or say she lied. I couldn't understand how my assessor had ever successfully worked as a nurse either. But one just has to hope for karma at some point in their lives.