Doing a PIP MR

quest4me2

I have just had my reassessment for PIP it has taken 11 months and I underwent a telephone assessment last year and then the DWP wrote to my GP for a medical report.

I was awarded the standard rates for both Daily Living and Mobility which was the same as I was getting previously. It has been awarded for a further two years.

I got 11 points for the Daily Living Activities (up 2 points from my last claim) and 8 points for Mobility Activities (same as last time but for different descriptors)

However, compared to my previous claim in 2017, they have awarded 0 points for descriptor 1 in Mobility Activities “Planning and following journeys,” whereas previously I got 4 points and met the descriptor B “Needs prompting to be able to undertake any journey to avoid overwhelming psychological distress to the claimant.”

I feel this is a mistake because if anything I find it more difficult when out travelling compared to a few years ago and I wonder whether to request a Mandatory Reconsideration relating to this absence of points – I know they can look at the whole claim again. I would also like to challenge the 2 year award as I feel having been on DLA since 2007, switched to PIP in 2017, my disabilities have only got worse not better.

They state there is no evidence to award points for this in my claim but there is and was and I especially referred to an incident last year in which I missed an important medical appointment because I couldn’t use public transport (and whilst I drive I couldn’t for this appointment due to the treatment I was having)

I can drive locally to places I am familiar with but would be uncomfortable and suffer psychological distress if going to a new or unfamiliar place, for instance I have been driving 8 years but have never driven to my friends some 30 miles away. I also avoid driving at busy times as there are many schools close by and I am uncomfortable with driving during those times.

However, I was wondering if I can submit further evidence with a MR which would back up this descriptor evidence which was not available when my original reassessment claim was done last March.

Further evidence is a report which confirms I have Autism after a recent assessment (I was referred last year via the mental health team for an assessment) and this could back up my psychological distress issues around taking journeys I am not familiar with, and it is caused due to sensory issues, noise in particular. I should also add I don’t actually have anyone who encourages me or supports me to go out as I am alone and rather isolated.

Thoughts on this?

Spoonie_Turtle

If you had the difficulties you describe at the time of the assessment then yes you could do an MR.  Although the medical evidence about autism wasn't available at the time, autism isn't something that could have started after the assessment so it is relevant to the time the decision was made.

If you are doing an MR you may as well make a case for a longer award too.  Was it 2 years in total or do you mean the award now has 2 years by the time they made the decision?  Not that it makes a huge difference but a 2 year award is rather short, 3 years is fairly standard.

I should also add I don’t actually have anyone who encourages me or supports me to go out as I am alone and rather isolated.

It is based on what help you need, not what help you actually get.  So if you *would* be able to do journeys with someone to support you (before or during), if you need the help to do that, tell them. 

poppy12345

Descriptor B for following and planning a journey, "needs prompting to undertake any journey." Then you said you can travel on familar journeys with no problems so i can't see how you would qualify for this descriptor. A familiar journey is any journey. You need to be careful with contradictions here.

Have a look at this link to see if any other descriptors may apply for following and planning a journey. https://www.gov.uk/government/publications/personal-independence-payment-assessment-guide-for-assessment-providers/pip-assessment-guide-part-2-the-assessment-criteria#mobility-activities

Alice_Holt

Can you clarify the exact descriptors and points you scored for both DL and mobility for this assessment, please. 

And for the mobility component in your last award.

quest4me2

Alice_Holt said:

Can you clarify the exact descriptors and points you scored for both DL and mobility for this assessment, please. 

And for the mobility component in your last award.

Sorry for the slow response, this was how I was awarded points in 2018

Daily Living Activities

Preparing Food

D

2 Points

Taking Nutrition

A

0 Points

Managing Therapy And Monitoring A Health Condition

B

1 Point

Washing & Bathing

B

2 Points

Managing Toilet Needs

A

0 Points

Dressing And Undressing

A

0 Points

Communicating Verbally

A

0 Points

Reading And Understanding Signs

A

0 Points

Engaging With Other People Face To Face

B

2 Points

Making Budgeting Decisions

B

2 Points

Total Daily Living Activity Points = 9

Mobility Activities

Planning And Following A Journey

B

4 Points

Moving Around

B

4 Points

Total Mobility Activities Points = 8

The 2022 Award

Daily Living Activities

Preparing Food

C

2 Points

Taking Nutrition

A

0 Points

Managing Therapy And Monitoring A Health Condition

B

1 Point

Washing & Bathing

C

2 Points

Managing Toilet Needs

A

0 Points

Dressing And Undressing

C

2 Points

Communicating Verbally

A

0 Points

Reading And Understanding Signs

A

0 Points

Engaging With Other People Face To Face

B

2 Points

Making Budgeting Decisions

B

2 Points

Total Daily Living Activity Points = 11

Mobility Activities

Planning And Following A Journey

A

0 Points

Moving Around

C

8 Points

Total Mobility Activities Points = 8

Hope this helps, to clarify since the 2018 award I have got a confirmed diagnosis of a mobility difficulty of which there was no ‘official’ evidence for the claim in 2018, despite me having the injury for 11 years I only got an MRI scan in 2018 to confirmed the damage which backed up my mobility difficulties.

The decision maker has gone against the advice of the HP in the PA4 report this time, for instance they didn’t want to award any points for the Mobility Activities scoring me with 0 points for both descriptors as there was no evidence! I had a telephone assessment and they also asked for a report from my GP.

quest4me2

Spoonie_Turtle said:

If you had the difficulties you describe at the time of the assessment then yes you could do an MR.  Although the medical evidence about autism wasn't available at the time, autism isn't something that could have started after the assessment so it is relevant to the time the decision was made.

If you are doing an MR you may as well make a case for a longer award too.  Was it 2 years in total or do you mean the award now has 2 years by the time they made the decision?  Not that it makes a huge difference but a 2 year award is rather short, 3 years is fairly standard.

I should also add I don’t actually have anyone who encourages me or supports me to go out as I am alone and rather isolated.

It is based on what help you need, not what help you actually get.  So if you *would* be able to do journeys with someone to support you (before or during), if you need the help to do that, tell them. 

Thanks, I now have the ASC report which was somewhat strange to weird because they clearly picked up on things that I was not aware of.

I have gone for the MR and put it together the last two days, I feel I have to challenge those missing 4 points especially given what is written in the ASC summary relating to my distress when trying to go out due to anxiety and sensory issues.

It was a 2 year review as recommended by the HP, but when I look at the review date for 2024 it seems to run 3 years from the actual assessment and it took 8 months to make a decision after that. I have asked for them to review the award for a longer period.

quest4me2

poppy12345 said:

Descriptor B for following and planning a journey, "needs prompting to undertake any journey." Then you said you can travel on familar journeys with no problems so i can't see how you would qualify for this descriptor. A familiar journey is any journey. You need to be careful with contradictions here.

Have a look at this link to see if any other descriptors may apply for following and planning a journey.

Thank you for the link that was helpful, had to remove it as I am new!

During the telephone assessment and I sent further evidence before the assessment I did refer to a example of once using public transport to attend a medical appointment, it was a nightmare, resulted in a panic attack and I missed the appointment and couldn't re-book it for more than three months due to distress it caused thinking about going. By which point I then found out I had an issue with my vision which could have been caused by the delay in getting to the appointment. This has since got better but is being monitored more.

They seem to think because you can drive, you do not suffer OPD but there was ample evidence of things I do to avoid OPD when planning to go out, for instance I shop in the early hours of the morning to avoid traffic and other people - all documented in my health records.

I have also referenced another prime example of OPD stopping me from going somewhere, of which when I explained I couldn't attend due to mental health issues I was excused under some random law - for personal reasons I won't divulge what this is, but it was difficult to get out of as they expected me to attend with a support worker which I didn't have access to nor a friend for support.

And there was another incident weeks after my assessment which has impacted my day to day routine and going out causing yet more OPD, the police were involved for this and again I have submitted evidence to support this. Again I won't divulge for personal reasons, but I am started some therapy for this next week.

So, whilst I drive with difficult it means I can go to places but but these are local only and each and every time I go out it is a challenge. If I had my way I wouldn't drive anywhere but then if that was the case I wouldn't go out because I get too distressed when trying to use public transport. 

quest4me2

Thank you to all those who commented on this topic, it was helpful.

Just to clarify I had done an MR and submitted my reasons as to why I think some points are missing and backed this up with further evidence.

I am aware they will look at the whole award again and I am fine with that, I feel I do need to challenge this and am prepared to take that risk.

Just for background I was on DLA at the higher rates for 10 years, moved to PIP 2016 awarded 0 points, MR failed, went to tribunal 2017 which was the most distressing experience ever and I ended up trying to take my own life when they awarded 0 points, resulted in several days in the ICU.

Eventually was persuaded to apply for PIP again months later, again awarded some points but not enough, requested MR, decision not changed, requested tribunal but weeks after tribunal papers accepted DWP reviewed MR and original decision and offered to give me standard rates for both DL and MA activities which I accepted, I could have gone to tribunal again but I didn't want to put myself through it.

I shall try and remember to keep you updated on how this progresses, but I am not much of a forum person, I tend to read and lurk.

Alice_Holt

Sorry, I have only just seen your reply.

I think you are right to appeal.  
In your 2022 Daily Living (DL) award you have got points for both the physical and the mental health descriptors, so it would seem inconsistent to then remove the 4 points (awarded previously) for planning and following journeys for Mobility.
Particularly as your ACS report references these difficulties.

The decision to remove these points because you can 'drive' seems slightly perverse to me.  Any decision should not look at the ability to drive in isolation. It should also consider the ability to cope with both walking and using public transport. There is some case law around looking at journeys "holistically", and taking into account your ability to walk to the car, and then from the car to your destination. (Pipinfo in the link below may refer to this).

Also since you are only 1 point short of an enhanced DL award, I think you may wish to argue that additional points should have been awarded there.
For instance:
i) if your mobility has worsened - do you need to hold onto bathroom furniture / grab rails  to get up safely from the toilet.
     do you have difficulty bending round to clean yourself ?
If so then points should have been awarded. The use of grab rails is classed as an aid -  so, 2 points.

ii) does it take you a long time to cook and prepare a meal - if so could you argue that assistance is necessary for you to reliably prepare a meal ?  4 points rather than 2.

iv) do you just need prompting to engage face to face or would social support be needed (4 points) ?   Often the DWP decision maker will stop at the lower points descriptor rather than consider if a descriptor with higher points is more appropriate.   

Do take your appeal to tribunal if necessary, tribunal panels are very good at getting the complete picture from the claimants verbal evidence (opt to participate in your hearing so you can explain and clarify things).  More than 70% of PIP appeals succeed at tribunal. Your local advice agency may be able to help you with your appeal.


https://pipinfo.net/activities/planning-and-following-journeys

quest4me2

Thanks Alice_Holt for your helpful advice! I sent the MR off on Thursday so fingers crossed for a positive outcome.

In the 2018 decision, I was awarded the bathroom points (2) for having rails in my bath to help me get into the shower, this time they have awarded the points (2) for needing encouragement, I guess based around my mental health, a little inconsistent but of course they can only give points to one descriptor.

For both claims, I provided a OH assessment report, and it was an OH who asked my housing association to put in the rails. Since my original 2018 decision, my mobility in the bathroom has got significantly worse, especially having to climb into the bath to take a shower and admittedly I tend to use the sink to help me sit down on the toilet and get up, now I did mention this to the HP during the assessment, but said I could manage, I wasn't looking for the points for this.

As for the bathroom, I also provided information to the DWP that I am waiting to move and down for medical priority. but due to my under 50 age, over 40... I am struggling to get suitable accommodation to meet my needs for both the bathroom, (a walk in shower), and the mental health issues. Noise is a massive issue for me so it is not helped by living in a flat. I now realise the ASD is behind my endless noise sensory issues for most of my life.

I do require help and prompting to engage face to face, especially with those I don't know such as engaging with health professionals when in a crisis etc. If I get to know someone then I am normally ok but rarely make eye contact. For instance I have a supportive GP who I trust and who understands me, but seeing another GP would be very difficult.

I don't really need support from another person, if anything I couldn't cope with that because I would find it intrusive and annoying, yes I struggle but I get there in my own way and time, albeit slowly.

I shall keep you posted on what happens.

Alice_Holt

" I tend to use the sink to help me sit down on the toilet and get up, now I did mention this to the HP during the assessment, but said I could manage, I wasn't looking for the points for this. "

   Of course if you were awarded the 2 points for needing to hold onto something, then this would get you past the 12 points necessary for an enhanced DL award. It is entirely consistent with needing rails to get safely in / out the bath, and the points awarded for moving around.

  If you continue with an appeal, I would suggest that you aim for enhanced awards for both DL and mobility. Explain the need to hold onto the sink in both your submission and verbal evidence to the tribunal.