PIP confusing decision! Furious!

Sammy19897 · 26 March 2017 at 8:31PM

hi nannytone yeh it looks like I will have to put in a claim for esa.... its a shame I'm gutted as I enjoyed my work but its my workplaces policy and theres not much I can do about that

Muttleythefrog · 26 March 2017 at 8:34PM

Hmmm an interesting case... but I'm sure you'd prefer it wasn't. So the prognosis has led to you being refused. I presume the 'prognosis' in the PA4 assessment report (which if you have not got a copy of.. acquire without delay by requesting from DWP in call on Monday - should not for technical and tactical reasons be attempting a reconsideration without this document unless reaching month time limit) supports the DWP claim of longevity? If not then you probably have a strong case to argue the DWP DM has made a clear error in imposing their misinterpretation of your assessment and temporary problem. If it does support the DWP DM then that is confusing since at the assessment the HCP made it clear to you they were only interested in assessing your disabilities prior to this injury... and it is on those disabilities which you make your claim. Hmmm... struggling for any real advice here.. you may have success at MR... but definitely pursue on to tribunal appeal if necessary focussing on the descriptors you feel apply to you given your ordinary day to day disabilities. Surely you'd have a good chance.. since by that time your injuries may have faded to eliminate confusions. Be interested to see how this case plays out and hopefully you get more tailored advice here or from a welfare specialist such as at CAB.

..and yes.. consider ESA application if SSP runs out.

Sammy19897 · 26 March 2017 at 8:57PM

Thank you Muttley I wasn't aware of the PA4 assessment report or that I could gain access to it, i've already put in MR via letter as you see my second post, I'm going through a lot of stress and with the confusion I acted how I felt best at the time now doubting my decision to act so quickly. the assessor definitely made it clear that the assessment questions are based on what I could do before which she repeated the words frequently, my partner who cares for me even was witness. I have good evidence of my conditions and feel its all been pushed aside because I broke my leg, as if I'm not going through enough

it all seems so cruel

nannytone_2 · 26 March 2017 at 9:10PM

Sammy19897 wrote: »

hi nannytone yeh it looks like I will have to put in a claim for esa.... its a shame I'm gutted as I enjoyed my work but its my workplaces policy and theres not much I can do about that

you don't need to leave your job to claim ESA.
as long as you are not receiving SSP you can claim ESA whilst remaining employed

Sammy19897 · 26 March 2017 at 9:15PM

nannytone wrote: »

you don't need to leave your job to claim ESA.
as long as you are not receiving SSP you can claim ESA whilst remaining employed

I will be made redundant on grounds of sickness because of my works policy so ill have no choice but to leave it behind me

Alice_Holt · 26 March 2017 at 9:56PM

I wonder if the DWP Decision Maker made a mistake and related the points awarded in your assessment to your broken leg (hence you not achieving the 9 months forward test).

So I would hope the second DWP Decision Maker would carefully consider your MR, since it clearly differentiates between your pre-existing conditions (which the assessor stated she was basing her report on) and the broken leg. I would hope the DM would review the assessment to check that the assessment points were indeed based on your pre-existing conditions. This may lead to a change of the decision at MR stage.

If the MR notice doesn't change the decision, then you need to lodge an appeal with the Tribunal Service (TS). This guide explains the process:
http://www.advicenow.org.uk/guides/how-win-pip-appeal

Getting a copy of the medical assessment (as suggested by Muttley) is sensible. If it's very clear that the assessor did write the report based on your pre-existing conditions and it has been misinterpreted by both the DWP DM's - then I suggest you consider (in addition to continuing with the appeal to the TS) making a compliant to the DWP about those decisions.
https://www.gov.uk/government/organisations/department-for-work-pensions/about/complaints-procedure
You may wish to involve your MP.
This is an unusual step to take, but I suggest it because it may lead to a quicker resolution than the appeal.

Getting help with your appeal from your local CAB is sensible. They can also do a benefit check, and advise on claiming ESA when your SSP ends.

Good luck. Let us now how you get on as we may be able to help with any further developments.

Alice_Holt · 26 March 2017 at 10:40PM

Sam,
Another thought.
Towards the end of the medical assessment (PA4), the assessor usually recommends a date for the next assessment. If this is more than 9 months (say 2 years), then it clearly indicates the assessor is looking at your long-term conditions and not the short-term effects of your broken leg.
May be useful additional evidence if you need to complain / continue the appeal.

Muttleythefrog · 26 March 2017 at 11:25PM

Alice_Holt wrote: »

Sam,
Another thought.
Towards the end of the medical assessment (PA4), the assessor usually recommends a date for the next assessment. If this is more than 9 months (say 2 years), then it clearly indicates the assessor is looking at your long-term conditions and not the short-term effects of your broken leg.
May be useful additional evidence if you need to complain / continue the appeal.

Vitally important here... frustrating the MR already made (although I wonder if they'll still have time to add comment into the process for MR after acquiring PA4.. in requesting the PA4 they can ask for confirmation their MR has been received for peace of mind)... and that DWP don't as standard supply the evidence they use to make decision. It is scandalous that PA4 and ESA85 are not as standard supplied with decisions where they exist for claims of PIP or ESA... bearing in mind many claimants evidently are... and I say this politely... clueless (due to ignorance or disability etc) about the process or its composition or their rights and options. But that 'prognosis' detail here could be key. For the reference of Sammy... it'll be in three places in the report... at end of Daily Living section and at end of Mobility section..then after the mobility section will be the second image format. (Taken from my PA4)

Cyclamen · 27 March 2017 at 8:23AM

No practical help here but I really hope they sort this out.

I have been ill since 2009.. I had my PIP changeover late last year and following a fall was in a knee brace which obviously restricted me a fair bit. I told my assessor it was a temporary thing and not part of the reason I was claiming and as i received my claim I assume it was ignored.

So it very much seems to me that something has gone very wrong with your report. I hope its all remedied soon.

Sammy19897 · 28 March 2017 at 11:05PM

Alice_Holt wrote: »

I wonder if the DWP Decision Maker made a mistake and related the points awarded in your assessment to your broken leg (hence you not achieving the 9 months forward test).

So I would hope the second DWP Decision Maker would carefully consider your MR, since it clearly differentiates between your pre-existing conditions (which the assessor stated she was basing her report on) and the broken leg. I would hope the DM would review the assessment to check that the assessment points were indeed based on your pre-existing conditions. This may lead to a change of the decision at MR stage.

If the MR notice doesn't change the decision, then you need to lodge an appeal with the Tribunal Service (TS). This guide explains the process:

Getting a copy of the medical assessment (as suggested by Muttley) is sensible. If it's very clear that the assessor did write the report based on your pre-existing conditions and it has been misinterpreted by both the DWP DM's - then I suggest you consider (in addition to continuing with the appeal to the TS) making a compliant to the DWP about those decisions.
You may wish to involve your MP.
This is an unusual step to take, but I suggest it because it may lead to a quicker resolution than the appeal.

Getting help with your appeal from your local CAB is sensible. They can also do a benefit check, and advise on claiming ESA when your SSP ends.

Good luck. Let us now how you get on as we may be able to help with any further developments.

Muttleythefrog wrote: »

Vitally important here... frustrating the MR already made (although I wonder if they'll still have time to add comment into the process for MR after acquiring PA4.. in requesting the PA4 they can ask for confirmation their MR has been received for peace of mind)... and that DWP don't as standard supply the evidence they use to make decision. It is scandalous that PA4 and ESA85 are not as standard supplied with decisions where they exist for claims of PIP or ESA... bearing in mind many claimants evidently are... and I say this politely... clueless (due to ignorance or disability etc) about the process or its composition or their rights and options. But that 'prognosis' detail here could be key. For the reference of Sammy... it'll be in three places in the report... at end of Daily Living section and at end of Mobility section..then after the mobility section will be the second image format. (Taken from my PA4)

Thank you Alice and Muttley, on Monday I requested the PA4 as you advised and checked the progress of my MR which still is yet to be looked at, so hopefully enough time before any decisions are made, I will update you all once I get that through the post. And Alice I'm wondering the same myself whether they had just given me points in regards to my broken leg instead of my actual long term conditions, I keep hoping that hopefully the DM calls me again like he did previously so I can have a long chat with him to clear this up, I'm not after both higher rates just some support would be appreciated and I know full well that I'm definitely entitled to some form of help as these conditions are a constant impact in my life just a shame it has to go down this route.

PIP confusing decision! Furious!

Comments

Categories

Get our FREE Weekly email full of deals & guides - and it’s spam-free