Tuesday, 25 October 2016

Appealing PIP Decisions

Below is a basic description of the steps for appealing PIP decisions. Please note that when you appeal a PIP decision then the Department of Work and Pensions (DWP) can review the entire award at the Mandatory Reconsideration Stage. In addition, the tribunal can review the entire award which means that if you appeal a decision then it is possible that you can end up with a lesser award or no award, depending upon your case. Any decision to appeal should be based upon consideration of the possible descriptors that you may be eligible for and the probability of evidencing that this is the case.

Receive a decision

If you are unhappy with the DWP's decision and believe it is incorrect, you should apply for a mandatory consideration. 

​You have 30 days from the date on the decision letter to request a mandatory consideration. 
Mandatory Reconsideration

(You only have one month from the date of the decision to request reconsideration)

You can ask for a reconsideration over the phone, but you should confirm your request in writing.

When you ask for the decision to be reconsidered, you should explain why you think the decision is wrong. If you can, get evidence to back up your argument. 

Reconsideration takes 2-6 weeks.   
Mandatory Reconsideration Notice

Once a decision has been reconsidered, the decision maker will send you two copies of a 'mandatory reconsideration notice' to let you know the outcome. You will need the extra copy of the notice if you wish to appeal.

You have 30 days from the date you receive the mandatory reconsideration notice  to make

Appealing a Decision

If you are unhappy with the result of the mandatory reconsideration, you can make an appeal. 

Your appeal must normally reach the HMCTS within one calendar month of the date that the mandatory reconsideration notice was sent to you.

Appeals are made on the SSC1 form

The HMCTS will send a copy of your appeal to the DWP and ask them to provide a 'response' to explain how they came to their decision. The DWP must do this within 28 days.

Tribunal Hearing

You must be given 14 days' notice of the time and place of the appeal hearing. The appeal tribunal will be made up of a judge, a doctor and a disability expert.

The judge will ask you questions about the issues related to your appeal. You should be given the opportunity to explain your case.

To find out how long it will take for you to be able to attend a tribunal hearing after you have lodged your appeal, telephone 0300 123 1142 and tell them which tribunal centre you will be attending.

​Appeal Decision

You will get a decision notice on the day of the hearing or soon after.

If the appeal is unsuccessful, you can ask for 'statement of reasons' which will explain the decision.  You have one month from the date of the tribunal decision in which to do this.

If you disagree with the decision, you may be able to appeal further to an 'Upper Tribunal'. You can only do this if the tribunal has made a legal error. See the appeals factsheet for more information. 


Collecting Evidence for a Tribunal Hearing

It is up to you to bring forward evidence that supports your claim.  It is important to remember that you are not being asked about your condition as it currently is, but your condition as it was when you made your claim.  This means you should be prepared to talk about how your health was at that time. 

Some of the written evidence which the Tribunal will consider in the hearing:

Your original PIP questionnaire i.e. PIP2 form

The medical assessment report completed by the doctor or Health Care professional as part of the PIP Assessment. 

Reports requested by the DWP from any other medical source (a G.P, Consultant or Specialist you may have seen recently)

​Familiarise yourself with these documents before your tribunal hearing so you can answer any questions the  Tribunal Members may have about them. 

Oral Evidence

The oral evidence you give in the tribunal is very important.  Before the tribunal you should identify which activities (descriptors) apply to you (see a full list of the descriptors here​).   Identify the level of difficulties you have with these activities. Think about whether you can perform the tasks safely, to an acceptable standard, repeatedly and within reasonable time.    Make a note of the activities (descriptors) that you feel you satisfy and why. You can send this to the Tribunal Service before you attend the tribunal.  Keep a copy of this for yourself so that you can refer to it during the tribunal hearing.

If possible, review the answers you made in your PIP2 form.  Try to make sure there aren't any inconsistencies with your oral evidence or be prepared to talk about why what you wrote in the PIP2 form might not have properly represented your situation. 

Medical Evidence

You should back up your oral evidence with medical evidence. 

Ask your doctor, consultant, physiotherapist or other health care professional who knows about your condition to write a supporting letter.  Please be aware, you may be charged for this.

 It is important that your evidence does not just state what condition you have and the treatment you receive. It needs to deal with what how it affects your ability to carry out day-to-day activities. 

Make a note of all the medication you were taking at the time of your claim

Disability Benefits Centre

Contains deaf/HI accessible formats (Unless you know differently!).

Get advice or information about a claim you’ve already made for Disability Living Allowance, Attendance Allowance or Personal Independence Payment.

Disability Living Allowance (DLA)

If you were born on or before 8 April 1948
Telephone: 0345 605 6055 
Textphone: 0345 604 5312
Monday to Friday, 8am to 6pm
Find out about call charges

If you were born after 8 April 1948
Telephone: 0345 712 3456 
Textphone: 0345 722 4433
Monday to Friday, 8am to 6pm
Find out about call charges

British Sign Language (BSL) video relay service

To use the Disability Living Allowance video relay service you must:

first check you can use the service
go to the video relay service
Monday to Friday, 8am to 6pm

The video relay service uses a free plugin. You may need to change the security settings on your device to install this.

Alternative formats

Call to ask for alternative formats, such as braille, large print or audio CD.

Attendance Allowance (AA)
Telephone: 0345 605 6055 
Textphone: 0345 604 5312 
Monday to Friday, 8am to 6pm
Find out about call charges

British Sign Language (BSL) video relay service

To use the Attendance Allowance video relay service you must:

first check you can use the service
go to the video relay service
Monday to Friday, 8am to 6pm

The video relay service uses a free plugin. You may need to change the security settings on your device to install this.

Alternative formats

Call to ask for alternative formats, such as braille, large print or audio CD.

Personal Independence Payment (PIP)
Telephone: 0345 850 3322
Textphone: 0345 601 6677
Monday to Friday, 8am to 6pm
Find out about call charges

There’s a different number if you want to make a claim for PIP.

Next Generation Text (NGT) relay service 
Dial: 18001 then 0345 850 3322
Monday to Friday, 8am to 6pm
Find out about call charges

Find out more about the NGT service 

British Sign Language (BSL) video relay service

To use the Personal Independence Payment video relay service you must:

first check you can use the service
go to the video relay service
Monday to Friday, 8am to 6pm

The video relay service uses a free plugin. You may need to change the security settings on your device to install this.

Alternative formats

Call to ask for alternative formats, such as braille, large print or audio CD.

Postal address for DLA Adult (aged 16 and over)
If you were born on or before 8 April 1948

Disability Living Allowance DLA65+ 
Mail Handling Site A 
Wolverhampton 
WV98 2AH 

Make sure you include your date of birth to confirm you’re 16 or over.

Postal address for DLA Child (under 16)
Disability Benefit Centre 4 
Post Handling Site B 
Wolverhampton 
WV99 1BY 

Postal address for Attendance Allowance
Attendance Allowance Unit 
Mail Handling Site A 
Wolverhampton 
WV98 2AD 

Complain about the Disability Benefits Centre.

Contact the Department for Work and Pensions to complain about the Disability Benefits Centre.

Last updated: 25 October 2016

Wednesday, 5 October 2016

Questions you may be asked at your medical assessment.

What questions you are asked will depend on what your health conditions are, whether the HP is using PIPAT software and how good they are at their job. Below are some of the questions thatare likely to be asked:

Your health conditions and treatment:

What are your main conditions?
How long have you had these conditions?
What medication do you take?
What side effects are there?
Who do you see about your conditions?
When did you last see them?
Have you seen a specialist?
Have you had any hospital admissions in the last 12 months?
What investigations have been carried out or are planned for the future?
Has there been any change in your condition?
What treatment have you had and how effective has it been?
Is any further treatment planned?
Does your condition vary?
What are your good days and bad days like?
What symptoms do you have?
How do these affect you and what difficulties do they cause?
Social and occupational history
Do you live in a house or a flat?
How many stairs do you have?
Is the toilet upstairs or downstairs?
Does anyone else live with you?
Can you get around all areas of your home?
Are there any modifications or adaptations?
What work do you normally do??
Have any adjustments been made to enable you to continue working?
Have you given up or changed work?
If so, was it due to your health condition or impairment?
What social and leisure activities do you enjoy and have you given up or modified any due to
your health condition or impairment?

Functional history and the typical day

What time do you go to bed?
How well do you sleep?
What time do you wake up?
Can you get out of bed and get dressed?
Does anybody help you?
Do you shower or bathe?
Do you have problems getting on or off the toilet?
Do you do your own cooking?
What kind of cooking do you do?
Can you follow a simple recipe?
Do you have any problems with swallowing?
Do you go to the supermarket or the local shop?
Do you walk or drive to the shops?
How long do you shop for?
How far can you walk?
Can you go to unfamiliar places?
Would you ask someone you didn’t know for directions?
Do you need someone with you when you go to new places?
Do you have any hobbies or interests?
Do you watch TV?
What do you watch?
Do you use a computer?
Do you have friends?
Do you have a social life?
Do you like to spend time with friends or family?
Do you have a pet?
Do you feed your pet?
Do you have a telephone?
Do you phone your friends or family?
Do you use emails, texts or Facebook to contact your friends?
Do you deal with you own letters and bills?
How did you get here today?
Did you come on your own?

Questions you may not be asked at your medical assessment. Just as important as the questions you may be asked are the ones you quite possibly won’t be asked, but should be. If you don’t get the chance to give detailed information about how your condition affects your everyday activities then there’s a lot less chance of a fair decision being made. So, if you’re asked questions like:

Do you do your own cooking?
Can you get out of bed and get dressed?
How far can you walk?
Then it’s important that you also answer as if you were asked.
How long does it take you?
How well do you do it?
Do you need someone to help you?
Is it safe for you to do it?
Do you suffer pain, fatigue or breathlessness when you do it?
Do you suffer anxiety or get confused when you do it?
If you do it once, how long before you can do it again?
Do you need any aids or appliances to do it?
Is there a time of day when you aren’t able to do it, because of stiffness or fatigue, for
example?
Can you do it reliably, i.e. can you do it whenever you are asked to or need to?
How many days a week, on average, can you do it?

It’s hard to remember all the issues above when you are being asked a whole series of questions about your life. What you can do, though, is always try to remember the ‘but’, when answering any question the HP asks you. 

If you say ‘Yes’ to any question, is there a ‘but’ that you should add to make your answer more accurate?

Example Answers

‘Yes I can get out of bed, but not until about 15 minutes after I wake up because I am so stiff in a morning.’
‘Yes, I can cook a simple meal, but on most days I am too exhausted and depressed by the afternoon to prepare anything but a bowl of cereal or a sandwich, but even that task leaves me exhausted and in pain.”

Example and help tips for “What kind of cooking do you do?”

This activity considers your ability to prepare a cooked main meal for one person. When repling to this question you need to include problems with preparing food. In this context prepare means making food ready for cooking or eating. This can include things like washing, peeling and chopping food.

In your answer you need to explain any difficulties with cooking a meal. It may be that you are never able to cook or you may not be able to do all the tasks involved in cooking. Perhaps you only rarely manage to cook or you may only be able to cook on some days of the week.

It may be that you are too exhausted and unwell to set about preparing and cooking a main meal at all and this would need to be explained on the form. You may be able to do it but only with discomfort or pain or you may not be safe to do it.

If preparing food causes discomfort explain what activity causes discomfort and why. So you may say that chopping vegetables cause pain in your hands and wrists as your M.E. means that you experience pain, discomfort and muscle weakness in your hands and arms.

It may be that you have problems with concentration and memory so it may not be safe for you to prepare a meal. Make sure that you record any problems with forgetting about pans, timing things and concentrating to cook a meal.

If you take a long time to do this activity because you need to keep stopping and resting make this clear. If you can do parts of the preparation but not all the preparing and cooking you may also score points in this section.

If you can do it sometimes it but feel unwell afterwards, explain that here. You may notice an increase in your symptoms or have to rest for a prolonged period after carrying out part or all of this activity.

Example answers and tips about“Mobility”

This activity is all about your ability to physically move about. The DWP say that this activity should be judged in relation to the type of surface normally expected out of doors such as pavements and kerbs.

Remember to take into account issues such as safely, reliably and repeatedly and whether you can walk the distance in a
reasonable time period.

For example, if you can walk 20 or 50 metres but only with discomfort and you cannot do so reliably or repeatedly you
should remember to tell them.

You can then explain in more detail about the problems that you have with walking, Tell them about how far you can walk before you experience issues like pain, severe discomfort, fatigue, breathlessness, muscle weakness etc. You also need to explain if you are not able to walk repeatedly and reliably. If there are days that you are housebound or bedbound you need to explain that you are not able to walk any distance out of doors on those days.

“I am able to walk a short distance but this exertion then causes an increase in my symptoms and may result in me needing complete bed rest for several hours”. 

Example answers and tips about “Do you deal with you own letters and bills?”

I become overwhelmed and find it hard to make decisions about budgeting, because of the pain and fatique it leaves me too exhausted to deal with paperwork and bills and I need help with managing this.

Example Answer and tips about “Do you have a social life, Do you like to spend time with friends or family?”.

This kind of question is about your ability to get on socially with other people when you are face to face. You may want to describe any problems with extreme fatigue or poor concentration here that means that you have difficulty following what people are saying to you and responding appropriately.

“I very rarely engage socially reliably and repeatedly as a result of my illness. I have lost confidence in dealing with these situations and I even avoid them due to the effect that they have on my health due to anxiousness in social situations, but I have to engage with strangers like today meeting you, this will leave me physically sick and anxious all day.”

Explain in detail when and how this effects your daily life.

Example answers and tips about “Dressing and undressing”.

This activity looks at your ability to dress and undress yourself.
If you often do not get dressed or undressed due to exhaustion or feeling too ill you can explain this here. If you have any problems with dressing yourself, perhaps because of problems with grip, muscle weakness or pains that make reaching or bending difficult explain this here.

Describe the problems that you have with this activity and any help that you require. If you do not get the help that you need perhaps you don’t do this as often as you would like or perhaps it is the only thing that you have the energy to do in a day.

Maybe you are not able to wear the clothes that you would like anymore as you need items that can be pulled on easily without buttons and zips. Perhaps you often stay in your nightclothes to conserve your energy.

If you can do this activity but it takes a long time and increases your symptoms mention this here. You may need to keep resting whilst dressing or undressing or afterwards.

I hope this has given you some idea of what questions maybe ask and how you should reply to them.

Be prepared for your assessment and at the end ask your assessor to read back any info they may have inputted and correct them if they have got it wrong.

I have personally helped some one who had many health issues and the medication he was on made them gain weight. The assessor in her report said “He arrived promptly for his appointment” infact the assessor was running late and he had to wait over a hour from his original appointment time. I politely said that this should be update with the information that he had to wait over an hour which left him in severe discomfort which could clearly be seen has the receptionist ask if he was alright and if he needed any help.  The assessor was clearly annoyed :-) but did update her original info.

Then the assessor said in her report that “Mr ??? was of neat and pleasant appearance and needed no help whilst at the assessment” Again I pointed the fact out that the receptionist was concerned about Mr ???. and Mr ??? had a big hole in his tshirt. Yet again the assessor was clearly annoyed :-) but corrected her mistake.

What annoyed me the most the assessor said “he was a lean muscly build”. Mr ??? was 32 stone in weight ???. 32 stone is no where near lean and muscly. So it is important that you get them to read back any data they have inputted you have a right for them to do this so make sure they do.

I really should have started this with When you are at your assessment ask for full details of the assessor :-). All doctor and
nurses need to be registered. Asking for there full name and PIN Number. If they say who I am not giving that.  Health service providers are accountable to both the criminal and civil courts to ensure that their activities conform to legal requirements. 

In addition, employees are accountable to their employer to follow their contract of duty. Registered practitioners are also accountable to regulatory bodies in terms of standards of practice and patient care (RCN et al., 2006).

The law imposes a duty of care on practitioners, whether they are HCAs, APs, students, registered nurses, doctors or others, when it is “reasonably foreseeable” that they might cause harm to patients through their actions or their failure to act (Cox,2010).

HCAs, APs and students all have a duty of care and therefore a legal liability with regard to the patient. They must ensure that they perform competently. They must also inform another when they are unable to perform competently.

In order for anyone to be accountable they must:

• have the ability to perform the task
• accept the responsibility for doing the task
• have the authority to perform the task within their job description, and the policies and protocols of the organisation.

So having there correct detail is important. You can check on midwife and nurses here:

http://www.nmc-uk.org/search-the-register/

To check up on a Doctor go here:

http://www.gmc-uk.org/doctors/register/LRMP.asp

Tuesday, 20 September 2016

The Revised PIP Assessment Guide

On the 1st September the Department for Work and Pensions (DWP) published a revised version of the Personal Independence Payment (PIP) Assessment Guide.

This document provides guidelines for the benefit assessors and helps them to determine the eligibility of claimants. The revised document explains the changes that have recently been made to the PIP assessment criteria following the second independent review of the benefit. As a result of the review, the DWP has made changes to two of the daily living components, redefined what is classified as an aid or appliance and adapted the ways that claimants, who are deemed to require it, can receive additional support with the application process.

For a full explanation of all the recent changes that have been made to the PIP assessment criteria you can download a copy of the latest assessment guide HERE 

Sunday, 11 September 2016

CAB: How to claim PIP...

Making a claim for the benefit Personal Independence Payment (PIP) can take a long time. It can often take up to 4 months from starting the application to getting your money (if you’re terminally ill your claim will be processed more quickly).

If you’re moving from DLA to PIP your payments won’t stop while you’re waiting for your PIP claim to be processed, as long as you make your claim for PIP within a month of being told by the DWP that you should.

You should make sure you’re prepared and have all the relevant information to help you make your claim.

Your first payment for PIP will start from the date you make your claim and cover the length of time it takes the Department for Work and Pensions (DWP) to make its decision. If you're moving from DLA to PIP, your PIP payments will start the day after your DLA stops.

The claims process

There are 3 stages to your claim:

(1)  Start your claim by calling the DWP


(2)  Fill in the claim form they send you

(3)  Go to a face-to-face assessment - most people have to do this (but you won’t if you’re terminally ill)

It can take up to 2 weeks for the DWP to send you a PIP claim form. While you wait, it’s a good idea to think about how you’ll fill in the claim form and if you need any supporting evidence.