Mandatory Reconsideration

System

This discussion was created from comments split from: Mandatory Reconsideration.

i_like_cats

I recently got turned down for an award - some points but less than 8 - and am currently working on my MR letter / form.

I understand you should stick to the facts when you are writing it. Keep it focused on the errors they have made. Point out precisely which categories you are most strongly appealing.

Still, surely you should put in a line or two just to state your opinion that the PA4 form shows that the telephone assessor either didn't understand, or mis-represented everything you said, & left out all the important detail, and reached ridiculous conclusions, etc?

As a consequence the decision-maker made their decision based on a really partial and inaccurate report (though I understand they'll also have looked directly at what I wrote on my form as well).

I don't want to out myself, but one example is they took my being able to pay a £10/month direct debit phone bill (out of £400 universal credit) as evidence that I was able to handle complex financial planning…. Despite all the other evidence of my life showing money troubles, massive credit card debt, inability to plan for medium or long term goals, never having done the things that DO require complex planning (e.g. owned a vehicle, owned a property, saved for a holiday, etc.) I suppose I am not literally under the court of protection, but I am not budgeting or managing money well, either.

They also took my not being able to monitor my condition or get the right support I need, as prove that I don't need any support because I'm not currently getting any! Despite my being non-functional and mostly housebound.

My being able to say "Return to XX please, driver" on a very familiar journey that I make once a week is apparently proof of my being fully capable of engaging with strangers and to travel without any difficulty.

Etc, etc.

I do think there's a big backlog of re-assessments as the guy on the phone said I would have plenty of time to submit my form when I phoned up to start the MR process. I'll get it in soon, though.

peteuk

https://forums.moneysavingexpert.com/discussion/comment/81955712#Comment_81955712

Quick point of advice start a new thread, that way you can get the advice you want clearly. I’ve reported your post and requested it be split. I will then give you a response to many of your points raised.

i_like_cats

https://forums.moneysavingexpert.com/discussion/comment/81955952#Comment_81955952

Thanks, I've put in that request.

These are the best grounds I have for arguing for more points I think: budgeting, engaging with other people, managing/monitoring my condition, and journeys.

I've been looking at PIPInfo.net which I was directed towards by a charity and has lots of case law. My issues are around deafness and anxiety. One ear is completely deaf, the other has mild-to-moderate hearing loss which affects the higher frequencies, i.e. speech. However if I am in an environment where there is only a single sound source, such as taking a telephone call in a silent room, I am able to do that fine. I have my hearing aid + CROS aid in my ears all of the time apart from when I am sleeping or showering.

My submitted supporting evidence was my audiogram and the name of a recent psychologist I'd seen. In my decline letter I just got the 4 points which seem standard if you are deaf/partially deaf, in relation to requiring an aid and for showering.

Journeys should have scored something. I cannot drive a car and I can't really safely ride a bicycle (my deaf ear faces the road). I almost never go to new places alone and I've only been abroad 3 times in 15 years, to stay with people I knew, and that was during better times.

I have a long history of binge-eating when I am somewhere crowded (multiple sensory inputs / motion / general fear-response). This happens when I get the bus into town, I end up binging on sugar to numb myself out. I don't know if this counts as overwhelming psychological distress but it doesn't sound like a zero either.

I obviously sounded too 'good' on the phone but I was in ideal conditions - alone, in my bedroom - and it's ridiculous for the assessor to have generalised outwards from that. I took the assessment alone but really I could have done with someone with me to help keep me on track. I told the assessor I had notes in front of me I'd like to refer to during the call. She never did ask me if I wanted to check my notes, and I got taken up with the conversation as she directed it. I guess this is how it is supposed to work but it meant I forgot to make certain points. And bizarrely she counted against me the fact I was able to carry out the call without someone else in the room, when my single sided hearing was the reason I could not have someone in the room.

I am uncertain what counts as recognisable 'therapies' for that question. For example I am sure I could get prescribed SSRIs if I asked the doctor, but I have never been interested, since a friend committed suicide after being put on them, and also certain groups I attended & people I read in the past were quite anti-medication. Even if as a consequence I am wracked with anxiety, at least I'm still "me" some of the time. I have had plenty of talk-therapy in the past and I don't think I could reasonably expect to get any more from the NHS. I did get some CBT privately in October-November through my parents but it was very expensive and I just think exercise and increasing my social engagement would be better (I'm very isolated). That sort of therapy tries to encourage you to take action anyway, e.g. joining a gym, and with a limited financial pot, sometimes just taking the action is what you need to do. But often I end up neither taking any therapy nor the action. That itself shows I am not managing.

More generally I think it's hard to describe anxiety and dissociation which you experience internally, and I think it counted against me that I sounded articulate and self-aware during the call. When actually most of the time I am zoned-out and not focused on my actual life. Dissociation not in the sense of multiple personalities, but being stuck in loops of rumination or future fears and detached from the day I'm living in. Anyway the psychological / psychiatric aspect of my claim was just totally ignored since I'm not on medication and haven't been sectioned. The account of the professional help I'd received in the past 10-15 years was also garbled and omitted by the assessor in their notes; if it had been properly recorded it would have shown many years' evidence that I absolutely need help in managing therapy, and spiral downwards without such help.

peteuk

Simply put the PIP assessment is what you say backed with evidence. The assessor will write the easiest answer, so no evidence means it’s easy to support a zero score.

For example claimant suffers with gout, no preventative medication or analgesia prescribed so therefore gout is not a significant issue to impact the ability to…

it does mean the claimant doesn’t have gout, it just means it doesn’t reach the high threshold of PIP.

I’ve said on another post that each activity is allocated to a physical, mental or cognitive condition (some have dual or part allocation) So if you don’t declare a certain type of condition the assessor will automatically zero certain activity. For instance if you dont declare a physical condition mobility activity 2 moving around is zero’d.

Just because you are in debt doesn’t prove you cant budget, the debt is not an issue, the reason why your in debt is the issue and it has to be down to a condition. My sons crap with money, it burns holes in his pocket, he has it, he spends it and then the last two weeks before he’s paid he’s skint. He pays his mobile phone bill no problem… for PIP this evidence needs to the be backed up with a condition with enough evidence to show severity. For instance referral and specialist letters, medication, therapy etc.

Spoonie_Turtle

Just to point out for the OP that the PIP assessment and actually whether you qualify for PIP can be two different things. It's useful to know what happens for assessments and why, but it's also very important to understand what in reality does count according to the law.

So you'll have one outcome from the assessment, but the outcome at tribunal may very well be completely different - and in ~70% of cases that go to tribunal, it is.

Journeys should have scored something. I cannot drive a car and I can't really safely ride a bicycle (my deaf ear faces the road). I almost never go to new places alone and I've only been abroad 3 times in 15 years, to stay with people I knew, and that was during better times.

I have a long history of binge-eating when I am somewhere crowded (multiple sensory inputs / motion / general fear-response). This happens when I get the bus into town, I end up binging on sugar to numb myself out. I don't know if this counts as overwhelming psychological distress but it doesn't sound like a zero either.

The threshold here is truly very high though.

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

The descriptors for Activity 1 are -

1. Can plan and follow the route of a journey unaided. 0 points
2. Needs prompting to be able to undertake any journey to avoid overwhelming psychological distress to the claimant. 4 points
3. Cannot plan the route of a journey. 8 points
4. Cannot follow the route of an unfamiliar journey without another person, assistance dog or orientation aid. 10 points
5. Cannot undertake any journey because it would cause overwhelming psychological distress to the claimant. 10 points
6. Cannot follow the route of a familiar journey without another person, an assistance dog or an orientation aid. 12 points

You'd need to score at least 8 points to qualify for the mobility element, so if you would meet one of the lower-scoring descriptors it's not worth arguing.

teaselMay

Can you better articulate how being unilaterally deaf means that you should have received points for mobility? I don't follow and I'm deaf as a door post. I get how riding a bike is affected, although so many people, myself included in my youth, ride with headphones on loud it's a bit of a moot point, but there are no points for not riding a bike.

huckster

These descriptor assessment appeals are best handled by someone independent I.e. benefit advice services such as CAB. They will collect all relevant information and ensure that the claimant is able to put all key information forward for consideration.

The whole system needs to be totally reformed, with a new assessment process.

Spoonie_Turtle

The whole system needs to be totally reformed, with a new assessment process.

Scotland seems to manage just fine with the process as set out in official policy, for ADP. It's the assessment companies for England and Wales that cause the most problems for PIP!

peteuk

https://forums.moneysavingexpert.com/discussion/comment/81957927#Comment_81957927

I would add it’s not the inability to take a journey, as much as it is to plan. The fact that someone cannot drive, but has the ability to plan a route is the over riding principle, unless there is a cognitive condition that stops them from doing both. Op takes a bus, can they read a timetable, do they know the route and stops etc etc.

The threshold for OPD is so high, that concrete evidence is required. As it was explained to me, the though of going out the front door makes the claimant physically ill, which can not be controlled with medication.

born_again

Journeys should have scored something. I cannot drive a car and I can't really safely ride a bicycle (my deaf ear faces the road). I almost never go to new places alone and I've only been abroad 3 times in 15 years, to stay with people I knew, and that was during better times.

As per @Spoonie_Turtle post.

Take the above quote

Can't drive car, neither can many others, not something that would qualify as a scoring option.

Can't really ride a bike, Sounds like you do? What is hearing like in other ear?

Almost never go to new places alone, Sounds that you do sometimes. As to going abroad, means nothing at all. Last time we went (mrs gets pip) was 30+ years ago. Not a PIP scoring option, just because you have not been overseas.

Personally never even thought that you could use that as a reason.

You need to think long & hard on your answers.