PIP Assessment. Can a decision be made on information 2 to 3 years out of date?

antjj28

Hi

Ive been on PIP for some time now and my condition is slowly getting worse, I explained to the DWP how this was affecting me but did not get some of the points I thought I deserved. The DWP and HMCTS have based their decisions on a previous PIP assessment done in 2020 by phone and a Universal Credit assessment done face to face in 2019 (in which the doctor I saw refused to physically examine me because of the pain I was in) this was not referenced in their decision.

Basing their decision on information that is out of date seems very wrong to me but I cant seem to get a straight answer (from the DWP and HMCTS) as to why they feel it is ok.
Can anyone offer me any advice please? 
Thank you in advance and I hope I have posted this in the right place.
Regards
Tony

marcia_

 Other than filling in the form did you send any evidence of your deterioration? 

tifo

Interesting. Because it suits them i suppose.

The rules seem to be that the decision is made for the day of the assessment and some people get better by this time and some worse.

In my case i waited a year and half for the decision and it was made for the day of the assessment, I got 0 points, however my conditions were worse when i claimed in 2021. In my case, like yours, had they made the decision from the time i claimed i'd have got PIP. With my WCA i was more worse in 2019 than 2021.

So, it suited them to look at your previous assessment to give you 0 or lesser points and it suited them to look at my current position to give me 0 points.

In your case, it should be easy to get them to look at the affects of your conditions now and make a decision on that. The law helps you.

In my case it's impossible to get them to look at how I was when i claimed in 2019 and 2021. The law doesn't help me here.

Alice_Holt

Am I right in assuming you appealed and have had a tribunal decision?
What date was this tribunal ?
Have you requested a statement of reasons from HMCTS?


Can you set out the exact chronology please, and the awards you received (or not). It would be helpful if you can give us the points and descriptors awarded by the tribunal, and the additional points (and why) you think should have been awarded.

The tribunal should be looking at your conditions at the date of the disputed DWP decision.

Did you;
i) Write a submission for the appeal,
ii) Participate in the appeal hearing, and clarify / explain things?    



The DWP often include previous awards / assessments in their appeal bundle. This sets out the history of a PIP claim (and can be very useful for some appeals where the latest (flawed) assessment is inconsistent with the latest PIP2 form, evidence, and previous awards). 

A tribunal should focus on the disputed assessment, but previous assessments can be useful background info. Less so, in your case, if you explained your worsening condition and abilities in your PIP2 form and sent confirming evidence.
If you did this, and:
- the tribunal panel still specifically referenced a previous PIP claim (and preferred that as evidence) in coming to a decision which reduced your award from the potential points cited in your PIP2 form,
- then an upper tribunal appeal may be considered appropriate.   

However, this does depend heavily on the detail in your PIP2 form, supporting evidence you submitted to the DWP, your submission to the tribunal, and your verbal evidence at the hearing.
If you didn't do this, then the tribunal panel may not have had the evidence to counter the DWP case.
You can't successfully appeal to the upper tribunal (UT) on the basis of evidence that wasn't available to the First Tier Tribunal (FTT).  You can only successfully appeal if the FTT made an error of law (such as preferring one set on evidence to another without fully explaining why), and if this error in law has caused a lower award. 

Time limits apply to an UT appeal.   

antjj28

Hi All
Thanks for your interest in this. My condition worsened; I completed the newer form which asks you how things have worsened since the last assessment. As I was already on the higher rate for daily living their response implied those issues weren't important to the claim (I disagreed with that saying it meant and even bigger reliance on my wife for help)

I asked for an MR and listed my reasons why. They did give me additional points for a criterion in the mobility section I did NOT ask for, they said they gave me this after looking again my application and a letter from a specialist who actually stated that one aspect of my condition would never improve and would probably continue to deteriorate. In my response I acknowledged this and thanked them.

At this point I was going to accept those additional points and leave it at that but their reliance on the out-of-date assessments continued to play on my mind and so I went to HMCTS, they upheld the DWPs decision. I asked for a statement of reasons and received that when I was in hospital with pneumonia and as I am still recovering, I only got to read it a few days ago.

Im not going to go into too much detail but one comment from the statement of reasons says:
"This is not a self-assessment process and so it is not a matter of just accepting the Appellants account without taking into account all of the evidence and what we conclude the Appellant is reasonably able to do"
What I want to know is how can they (HMCTS) conclude what I am able to do based now based on evidence that is 2-3 years old?
The court has sent me the full evidence pack and both those assessments, 1 for PIP and 1 for UC are both part of the pack of evidence.

My application to have the DWP look at my claim again was started in July 2021
DWP replied with their decision October 2021
Sent MR request October 2021
Received the response to the MR January 2022
Sent appeal request to HMCTS February 2022
Received HMCTS decision in August 2022
Asked for and received Statement of Reasons in September 2022

I must stress that the issue I am concerned with here is the evidence they have used, if I was sent for a face to face assessment now, I am sure it would show a significant reduction in what I can and cannot do compared to 2/3 years ago. This may or may not result in an increase in my benefit payments but I am more interested in their information on my condition being accurate and up to date.

Tony

antjj28

Alice_Holt said:

Am I right in assuming you appealed and have had a tribunal decision?
What date was this tribunal ?
Have you requested a statement of reasons from HMCTS?


Can you set out the exact chronology please, and the awards you received (or not). It would be helpful if you can give us the points and descriptors awarded by the tribunal, and the additional points (and why) you think should have been awarded.

The tribunal should be looking at your conditions at the date of the disputed DWP decision.

Did you;
i) Write a submission for the appeal,
ii) Participate in the appeal hearing, and clarify / explain things?    

Hi Alice
I did not attend the appeal hearing in person, I don't think I could have coped with the stress

born_again

While I get what you are saying on using old evidence. If you are already on the daily higher rate, does it make any difference what evidence they use, as you would not get a further increase.
 As you would be able to get carers allowance (subject to not earning too much) on that result anyway (as I do from my wife's pip)
So not really sure on the point of adding more stress to a already stressful situation. Sometimes it is better to just go with the flow & only counter when they have got it wrong & knocked points off.

calcotti

antjj28 said:

As I was already on the higher rate for daily living their response implied those issues weren't important to the claim (I disagreed with that saying it meant and even bigger reliance on my wife for help)

At a tribunal once they have decided there are sufficient points to award the higher rate they will stop looking at other issues. The purpose of the decision process is not to describe your needs but simply to establish what level of benefit you are entitled to.

Alice_Holt

(In response to your reply timed 1.43pm)

Hi,

    I've added a para to my previous post (edited @ 1.47pm) which expands on considerations for a UT appeal. There has to be on an error of law by the FTT, and this error of law then resulted in a reduced award.

Since you are on enhanced DL already, there is absolutely no point appealing about that. That is the highest DL award you can get. There is no sense in challenging your DL award on the basis that you think more points should have been awarded - (see the reply by calcotti). 
 It would be a senseless waste of your time and HMCTS's time. It also (for you) carries a risk of losing that highest award, especially as you elected not to participate in your hearing.


I assume you appealed because you were expecting an increased Mobility award. So....

....Did your PIP2 form (and your evidence) show why this should be the case ?
I realise that you " not going to go into too much detail"  , but again we can only usefully comment further if you share:
 the mobility points and descriptors awarded by the tribunal: 
 the additional points you think should have been given for mobility and why.  




In saying - "This is not a self-assessment process and so it is not a matter of just accepting the Appellants account without taking into account all of the evidence and what we conclude the Appellant is reasonably able to do"  - the tribunal are correct. It is their job to come to a decision about the DWP decision based on the evidence in front of them.
This is why is is so vital to:
i) Write a compelling PIP2 form with evidence for the DWP
iI) Write a submission for the appeal,
iii) Participate in the appeal hearing, and clarify / explain things

The tribunal then have your evidence to counter the DWP evidence.

They have to explain why, in coming to a decision, they prefer the one set of evidence against the other. Failure to do so adequately is an error in law.    

poppy12345

If you already had Enhanced daily living, what mobility award did you have before you requested the Tribunal?

poppy12345

OP was last active at 3.33pm but didn't comment on the thread. If there's an Enhanced for both parts award then i really don't understand why they took it to Tribunal. Not only that they requested the Statement of Reasons. This is wasting their time, the panels time and the Judges time when they needed to do the SOR, which as we know takes up a huge amount of their time.