PIP - has a claim been rejected and we don't know?

Alice_Holt

moneyunwise said:

Thanks, I will update although won't be immediate. 

A question for the people on here who seem to know the process - is there an organisation who can get onto the call who know the process and ask for clarification? I get the impression that the social worker is there to help her give answers but not know the details of the process.

    Her local advice charity.  Be aware that demand for their services greatly exceeds their resources, 

   However for a phone call to chase up, it's probably better for her to make the call with you / a family member present. She can better involve her local advice charity if there are complications to follow up with the DWP, or an appeal is needed. 

    As Mutley says for a new application she should have received the decision letter by now.
   She has an absolute 13 month deadline to appeal a rejected application (with good reason) otherwise it's a month from the date of her decision letter.

Aligogs

moneyunwise said:

....is there an organisation who can get onto the call who know the process and ask for clarification? I get the impression that the social worker is there to help her give answers but not know the details of the process.

To be honest, you don't really need anyone to know the process...the individual/applicant can ask for clarification.... PIP/DWP will give that clarification...as best they can. 

The social worker can support the applicant to make that phone call, anytime, and be in the room with them too.

Have you thought of talking to the social worker, as it sounds as though you both have the individuals best interest at heart? If you are financially responsible (or feeling that way), then these timescales affect you too. The social worker doesn't need to divulge the individuals case details to you, but I can't see any reason why a 'timescale' can't be sought for your behalf too.

CAB are pretty good too. But all needs to be done with the individuals consent...but be aware the more 'agencies/ people' you bring in to the picture, the more stressed/overwhelmed the individual may become.

peteuk

Muttleythefrog said:

The process for claiming PIP is fairly logical and straightforward in terms of protocol although there are significant delays in the system. 

I fear there may be incorrect or missing details here and as a 3rd party it could be tricky for you unless the claimant is prepared to let you see things like texts and letters received. I do worry that she may have sent a form back too late i.e. beyond the specified date required and I'm not sure how they would deal with such. However if she had some kind of assessment later then that would imply her claim was live or were they calling because of the lack of response. It's confusing and I do hope that you are getting honest feedback given your financial support.

Normally if an assessment is required (and for most claimants it is) then either in person or over the phone it will be done once and they will give their opinions to the DWP Decision Maker who will ultimately take the decision (often just a rubber stamping of the advice they've received from the healthcare assessment company healthcare professional). Normally a decision will be taken quite quickly after the DWP receive their commissioned advice.

Calling PIP can be a pain due to the time it takes to get through but they should be able to provide at least basic updates like 'a decision has not yet been made' or 'we sent a decision letters on date X' or 'we've just received the Healthcare professional's report' or 'we closed the claim as claimant failed to engage the process and sent letter on x'. With permission (if the claimant answers a couple of security questions) they will allow a 3rd party to deal with the call.

I would check her texts to see what updates they've provided.
I would check her post received.
I would then be inclined (if that doesn't shed light on current status) to then call PIP. Ask for copies of any documents apparently lost to be re-sent if relevant.

I do think it important to get on top of events here because if the claim results in an undesirable decision then challenging it can feature time restriction.

If your friend is evasive and you feel concealing truths from you while not allowing you to support them in getting factual information direct from the PIP helpline then you might have to evaluate what direction you take.

Late or none return of a form does and should not hold up the assessment process. As there are many reasons both inside and outside of the claimants control.   (Royal Mail being one of them) Assessors are given prep time prior to assessment, this enables them to look at the PIP2 or compare a review questionnaire against a the last previous PIP assessment.   Generally in such cases the initall assessment is slightly longer because the assessor has no base line knowledge from the PIP2, where as a PIP review can use the last assessment as a bit of knowledge eg. Conditions suffered, general effects. 

moneyunwise

Hi. I said I would give an update. She has a new social worker and after my pushing they contacted pip. 

She was rejected 2 weeks ago and the letter went to the wrong address. She is allowed to appeal but I don't know what is means for the last 2 weeks.

Reason for rejection was something about lack of supporting documents/evidence (I wasn't on the call). Now she and her social worker seem to think that is because the medical people who would have supplied those documents, did not supply everything. The other answer is of course, all the evidence was supplied and she does not have a case.

So she seems to be moving on the appeal with gusto due to pressure from the new social worker.

New questions:
How long before she must submit all her evidence?
How long do appeals take to get an answer?
If the appeal fails, we have a situation where she has no money for anything (except me and that has to stop) so no rent or food. It makes sense to me to assume the worst so what would we do? The social worker will advise I am sure but I like to know for myself.

In terms of the original decision, we did think that a decision would take up to 12-16 weeks from the last interview after reading online and it was in those timescales. Personally, I let her convince me that things would be done quickly and positively and this has been going since last February with a negative result. I cannot let that happen with the appeal.

8dayweek

Others on here can give better advice about the next steps with PIP as you won’t be at Appeal stage yet - rather the Mandatory Reconsideration stage. 

But, I just wanted to say PIP isn’t technically an income replacement benefit. If there is no other income they / you / the Social Worker should be exploring Universal Credit / new style ESA etc.

I will caveat this with its important they are honest with you before you go down this route - if they have an existing legacy benefit claim they’re not letting on about, and a UC application is made, then this will stop the legacy benefit (barring any contributions based benefits) and there is no way back. 

Alice_Holt

Details of the appeal process here: 

https://www.advicenow.org.uk/guides/how-win-pip-appeal

https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/pip/appeals/mandatory-reconsideration-pip/

First step is a Mandatory Reconsideration request to the DWP  (usually the original decision is upheld).
Then comes an appeal to tribunal. 

Good news is that c.70% of appeals succeed at tribunal.
Bad news is that time scales for a hearing are far longer than 16 weeks.

I'd reiterate my earlier suggestion to seek help from her local advice charity. Her social worker can support her in this, and attend with her. 

Who did her PIP2 form? 



Re -"If the appeal fails, we have a situation where she has no money for anything so no rent or food."

I don't understand this -  is she not claiming UC with the housing element, or ESA and HB, together with Council Tax reduction ? 

Spoonie_Turtle

Unfortunately it is basically the claimant's responsibility to send in any supporting evidence, they rarely contact medical professionals (depending on the situation).

Echoing the concern about having no other income - is there a particular reason they're not claiming anything else, or just didn't know to do so?

Muttleythefrog

Echo the above advices... sounds like she needs to put in a Mandatory Reconsideration (the missing letter would mention this option) and she or someone else should request copies of assessment reports. As was one of my theories it sounds like they've really struggled to get information from claimant on their disabilities. A part of me does wonder if they've concealed truths as I think they would have been sent text update also to say decision was coming or similar. How they managed to send a decision letter to wrong address I do wonder... I find that somewhat odd if they've otherwise been sending to correct address but human error perhaps in editing a document. I think she needs someone who understands PIP and its criteria to help her... in reconsideration request and any later appeal... while there are timescales I hope she doesn't bull-headed go into something she already may have demonstrated (possibly with her previous social worker) a failure regarding. 

And also on the income... PIP is a benefit to support those with extra costs of disability. She should surely have either other benefits or support or resources... and again a lack of transparency on such when you are financially supporting them out of your own pocket would be another red flag to me. 

peteuk

Just to echo the above - PIP dont contact the GP or hospital, the claimant needs to send the documentation in. 

As for the address, I would say it’s Royal Mail who have most likely sent it to the wrong address, as one of the checks at the start of the assessment is address, NI and DOB.  Simple checks, unless they have moved recently. 

If the apppeal is successful my understanding is it will be back dated to the point of application.  Had the assessment been successful that would have been the case.   PIP is a horrible assessment and very subjective. 

Good luck. 

Muttleythefrog

peteuk said:

As for the address, I would say it’s Royal Mail who have most likely sent it to the wrong address, as one of the checks at the start of the assessment is address, NI and DOB.  Simple checks, unless they have moved recently. 

My concern is "She was rejected 2 weeks ago and the letter went to the wrong address" - how would PIP know (there's no tracking) unless they confirmed in the call the address on the letter was wrong. (There is of course the possibility the details of the call are falsely conveyed too!) But I would be inclined to think either the claimant is lying (there are other indications of withheld info/evasion mentality) and they did receive it and probably also associated text, or someone at PIP has edited the decision letter and accidently changed to incorrect address (they're certainly capable of putting rubbish in these letters... my own decision letter recently sent has a glaring error in it) but unless as you point to any recent move they'd have no reason to start editing such in a document which I assume is largely case management generated. I think for the Op asking about other income and getting some good answers is important because if there is evasion or any lies they need to cut ties. I've found myself in such a situation with a disabled friend before... helped them overturn a silly PIP decision.. big backpayment but money I'd lent them apparently not for repaying.