PIP 13 months to appeal or just make a brand new claim?
alexnurse12052022
Forumite 18 Posts
I know you probably get this type of question a lot, I know the first responses will be "get official advice" I get that, and we will.
This is the situation
--> I've only known claimant for one week
--> Claimant had original PIP application and Mandatory Reconsideration refused within last 13 months, but more than 6 months ago. Don't have exact date to hand
--> Claimant has very complex muscular-skeletal condition, and there are global impairments and poor functioning across multiple daily living skills, in addition to very poor mental health at times. We are talking about metal plates in the body, surgery complications that have increased disability, significant deformities due to the condition, severe pain, difficulty eating and digesting food, weight loss, multiple medications, can't mix or socialise with others, the list goes on....Claimant did the claim on his own, and the MR, so we all know there is a risk (and it came to fruition) that there was multiple 0 points awarded in areas of his life where he is massively disabled. I've seen part of the decision letter which highlights this.
--> If we go for an appeal under the 13 month protocol we could be successful and he could get the backdate he would be entitled to, but are we potentially wasting time in waiting months and months for a possible Tribunal, only to potentially lose that based on an original problematic application in the first place?
--> If we start fresh, he can (via the correct advice support) do an application and evidence that really highlights his disability and impact on his daily life. Of course, we would still have to wait a few months to get a result.
--> Can we do both, but with a strong argument of a change in condition (hence still pursuing the original claim via appeal, AND doing a new claim or does that just !!!!!! the whole thing up?)
Thank you.
This is the situation
--> I've only known claimant for one week
--> Claimant had original PIP application and Mandatory Reconsideration refused within last 13 months, but more than 6 months ago. Don't have exact date to hand
--> Claimant has very complex muscular-skeletal condition, and there are global impairments and poor functioning across multiple daily living skills, in addition to very poor mental health at times. We are talking about metal plates in the body, surgery complications that have increased disability, significant deformities due to the condition, severe pain, difficulty eating and digesting food, weight loss, multiple medications, can't mix or socialise with others, the list goes on....Claimant did the claim on his own, and the MR, so we all know there is a risk (and it came to fruition) that there was multiple 0 points awarded in areas of his life where he is massively disabled. I've seen part of the decision letter which highlights this.
--> If we go for an appeal under the 13 month protocol we could be successful and he could get the backdate he would be entitled to, but are we potentially wasting time in waiting months and months for a possible Tribunal, only to potentially lose that based on an original problematic application in the first place?
--> If we start fresh, he can (via the correct advice support) do an application and evidence that really highlights his disability and impact on his daily life. Of course, we would still have to wait a few months to get a result.
--> Can we do both, but with a strong argument of a change in condition (hence still pursuing the original claim via appeal, AND doing a new claim or does that just !!!!!! the whole thing up?)
Thank you.
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The disadvantage is that if the persons PIP form, did not detail how his condition affected his ability to perform the PIP activities reliably, then it becomes harder at tribunal and more evidence would be needed. Person would need to attend, and give a full explanation of his difficulties at the time of the PIP decision.
2) If it's felt that the condition and abilities of this person have now worsened and an award is now merited - then a new application should be made.
3) If it's felt that the condition and abilities of this person merited an award when he applied, and continue to merit an award - then I'd consider doing both. Any new award would apply from the date of ordering a form through the PIP telephone line, whereas a tribunal date may be many, many months into the future.
The potential disadvantages of doing both -
i) DWP may use the previous report to turn down a new application (but this also applies to 2) )
ii) If the appeal is successful then the HMCTS decision will be time limited - from the date the first PIP form was ordered to the date of a DWP decision on the second application. However an MR of a second unsuccessful decision, enclosing the tribunal decision, is likely to get that decision reversed.
It would be sensible to get as strong a PIP form for the second application as possible, with supporting medical evidence, and prepared / helped by an advice agency that knows its way around the PIP criteria.
From what you write it would seem to have been a flawed decision, so one would hope that an appeal (with good medical evidence) will succeed, and the award then backdated. If he can get ongoing help from an advice agency, but can only cope with one option, that may be preferable to reapplying.
If he has a copy of his PIP form, that would be a useful document to show the advice agency.
Also he could get a copy of the assessment report from the DWP.
You say the general condition affects their mental health at times, for it to be considered it has to be the majority of times. If this can be proven then wonderful. But if they have discounted mental health this will carry a 0 score for some activities.
As for the general health, is there any specialist input for the knock on effect eg weight loss, or prescription from Gp for supplements? If so use it.
When I mentioned targeted, take cooking. It’s a simple meal for one on a hob, or in certain circumstances microwave. No oven use is taken into account so no requirement or bend or lift anything from the oven.
But you’ve hit the nail on the head, if you cant fully explain the effect of an illness, due to whatever reason and its not clear in the answers or questions then its going to give a false assessment and outcome.
Good luck with what ever outcome they choose.
Current debt ZERO.