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DLA to PIP Autism and Mental Health
- SnowDragon
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9 years 11 months ago #136090 by SnowDragon
DLA to PIP Autism and Mental Health was created by SnowDragon
Hi!
Autistic DLA claimant due to transfer this year to PIP. PIP form already filled in in readiness for when the official process takes place so it is ready to go off.
Current claim is HRC and LRM. We have some concerns regarding the possibility the LRM may be lost on transfer to PIP.
The claimant requires someone with them when they undertake unfamiliar journeys. They are OK with some familiar journeys.
The descriptor that seems to fit the applicant attracts 10 points and says:
"Cannot follow the route of an unfamiliar journey without another person, assistance dog or orientation aid"
The person would become extremely distressed at any disruption to the journey undertaken by public transport or road and has behavioural issues when outdoors. The accompanying person would also be navigating. As a result the current DLA and any future PIP is used for the additional cost having an accompanying person on a journey attracts.
However, when one looks at the official DWP guide available here it seems to guide the decision maker that this descriptor is not for mental or behavioural issues but for for someone who is blind.
We are concerned that if the recommended descriptor is used whereby:
"Cannot undertake any journey because it would cause overwhelming psychological distress to the claimant".
The claimant would immediately be committing fraud by undertaking a very familiar journey alone and effectively is rendered housebound unless accompanied.
It seems that those with mental and behavioural problems that require supervision and assistance when out and about are basically now screwed because they can potentially only score 4 points or appear to meet a 10 point criteria which is written to sound like it fits but hidden behind the scenes it is not applicable.
Any advice or thoughts welcome.
Autistic DLA claimant due to transfer this year to PIP. PIP form already filled in in readiness for when the official process takes place so it is ready to go off.
Current claim is HRC and LRM. We have some concerns regarding the possibility the LRM may be lost on transfer to PIP.
The claimant requires someone with them when they undertake unfamiliar journeys. They are OK with some familiar journeys.
The descriptor that seems to fit the applicant attracts 10 points and says:
"Cannot follow the route of an unfamiliar journey without another person, assistance dog or orientation aid"
The person would become extremely distressed at any disruption to the journey undertaken by public transport or road and has behavioural issues when outdoors. The accompanying person would also be navigating. As a result the current DLA and any future PIP is used for the additional cost having an accompanying person on a journey attracts.
However, when one looks at the official DWP guide available here it seems to guide the decision maker that this descriptor is not for mental or behavioural issues but for for someone who is blind.
We are concerned that if the recommended descriptor is used whereby:
"Cannot undertake any journey because it would cause overwhelming psychological distress to the claimant".
The claimant would immediately be committing fraud by undertaking a very familiar journey alone and effectively is rendered housebound unless accompanied.
It seems that those with mental and behavioural problems that require supervision and assistance when out and about are basically now screwed because they can potentially only score 4 points or appear to meet a 10 point criteria which is written to sound like it fits but hidden behind the scenes it is not applicable.
Any advice or thoughts welcome.
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- Gordon
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9 years 11 months ago - 9 years 11 months ago #136107 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic DLA to PIP Autism and Mental Health
Snowdragon
Welcome to the forum.
One minor point before I address your primary question.
The PIP2 form contains a unique bar code so you will need to complete the form issued by the DWP.
If you have read the guides then you will see that we strongly disagree with the guidance issued by the DWP, unfortunately we have seen a number of members only receive four points as a result of this guidance. That said members have been successful at scoring at the higher level.
The DWP argument revolves around "prompting" so you need to show that prompting is insufficient for your claimant and that they need attention for the whole of the journey. Think about the issues that they might have during a journey and why prompting would be unable to deal with these issues.
If you have used the guides then you should already be aware of the following.
Activities must be carried out reliably this means
• Safely – in a fashion that is unlikely to cause harm to themselves or to another person.
• To a necessary and appropriate standard – given the nature of the activity.
• Repeatedly – as often as is reasonably required.
• In a timely manner – in a reasonable time period.
and the claimant must be capable of doing them for the majority of days required.
Several claimants have had to go to appeal over this issue, so far I think the count is one fail and one win, there is currently no Case Law in this area.
Gordon
Welcome to the forum.
One minor point before I address your primary question.
The PIP2 form contains a unique bar code so you will need to complete the form issued by the DWP.
If you have read the guides then you will see that we strongly disagree with the guidance issued by the DWP, unfortunately we have seen a number of members only receive four points as a result of this guidance. That said members have been successful at scoring at the higher level.
The DWP argument revolves around "prompting" so you need to show that prompting is insufficient for your claimant and that they need attention for the whole of the journey. Think about the issues that they might have during a journey and why prompting would be unable to deal with these issues.
If you have used the guides then you should already be aware of the following.
Activities must be carried out reliably this means
• Safely – in a fashion that is unlikely to cause harm to themselves or to another person.
• To a necessary and appropriate standard – given the nature of the activity.
• Repeatedly – as often as is reasonably required.
• In a timely manner – in a reasonable time period.
and the claimant must be capable of doing them for the majority of days required.
Several claimants have had to go to appeal over this issue, so far I think the count is one fail and one win, there is currently no Case Law in this area.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 9 years 11 months ago by Gordon.
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- SnowDragon
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9 years 11 months ago #136120 by SnowDragon
Replied by SnowDragon on topic DLA to PIP Autism and Mental Health
Thank you Gordon for you fast response and advice.
The PIP2 form was downloaded for reference while detailed explanations have been prepared in a word document.
Do you know if one should refer to the descriptors and the points value estimated that the person should receive?
I find the DWP official guide book downloadable here to be quite absurd in this area of mobility requiring assistance. On the one hand the guide seems to steer away from Mental Health for descriptor 11b and states this.
Later under descriptor 11f the official DWP guidance states:
"Consider this example: a person with learning difficulties is left alone to walk home. If left in a familiar area can they safely and reliably get home, if not then 11f applies. If they can get home from a familiar location, move on to the next relevant descriptor in this category 11d. If they were left in an unfamiliar area for example a new shopping area in town, could they do this? If no 11d may be satisfied".
Autism can be strange in terms of benefits as it is not seen as "mental" but is more a cognitive development issue so perhaps those with Autism and such spectrum conditions are included in these 11b descriptors as the word "cognitive" appears in the DWP book.
If an award is made for daily living but no award for mobility is given can the mobility zero award be appealed without risking the care award?
We are puzzled on this as we know an Aspergers individual who successfully transferred from DLA LRM HRC to PIP Enhanced care Standard Mobility scoring 10 points in 11b. They were also awarded this with no independent medical exam and the person works part time in a well know DIY store yet scored heavily on "engaging with other people".
The PIP2 form was downloaded for reference while detailed explanations have been prepared in a word document.
Do you know if one should refer to the descriptors and the points value estimated that the person should receive?
I find the DWP official guide book downloadable here to be quite absurd in this area of mobility requiring assistance. On the one hand the guide seems to steer away from Mental Health for descriptor 11b and states this.
Later under descriptor 11f the official DWP guidance states:
"Consider this example: a person with learning difficulties is left alone to walk home. If left in a familiar area can they safely and reliably get home, if not then 11f applies. If they can get home from a familiar location, move on to the next relevant descriptor in this category 11d. If they were left in an unfamiliar area for example a new shopping area in town, could they do this? If no 11d may be satisfied".
Autism can be strange in terms of benefits as it is not seen as "mental" but is more a cognitive development issue so perhaps those with Autism and such spectrum conditions are included in these 11b descriptors as the word "cognitive" appears in the DWP book.
If an award is made for daily living but no award for mobility is given can the mobility zero award be appealed without risking the care award?
We are puzzled on this as we know an Aspergers individual who successfully transferred from DLA LRM HRC to PIP Enhanced care Standard Mobility scoring 10 points in 11b. They were also awarded this with no independent medical exam and the person works part time in a well know DIY store yet scored heavily on "engaging with other people".
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9 years 11 months ago #136128 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic DLA to PIP Autism and Mental Health
Snowdragon
There no problem with claimants referring to the Descriptors that they believe that they meet, but make sure that you fully understand the Descriptor and all of the discreet requirements, it's probably the most common cause of why claims fail, claimants see that the meet one requirement and ignore the fact that they don't meet the others that the Descriptor lists.
Whilst it is probable that the Decision Maker will always tend to follow the guidance I would make two points, it is just guidance and not the law so it is not set in stone and secondly, they are not medically trained, so a clearly set out argument of why one thing does apply and another does not, can make a big difference.
You can at both the MR stage and at appeal, request that only a single element of an award is looked at, but neither the DWP or a Tribunal panel are required to honour this and may extend their review to both elements if they feel it is justified.
In the majority of cases the risk to the un-appealed component is low, but we do, perhaps once a week or slightly less get a post from someone who has had the un-appealed component reduced or removed, so the risk is most certainly not zero.
Gordon
There no problem with claimants referring to the Descriptors that they believe that they meet, but make sure that you fully understand the Descriptor and all of the discreet requirements, it's probably the most common cause of why claims fail, claimants see that the meet one requirement and ignore the fact that they don't meet the others that the Descriptor lists.
Whilst it is probable that the Decision Maker will always tend to follow the guidance I would make two points, it is just guidance and not the law so it is not set in stone and secondly, they are not medically trained, so a clearly set out argument of why one thing does apply and another does not, can make a big difference.
You can at both the MR stage and at appeal, request that only a single element of an award is looked at, but neither the DWP or a Tribunal panel are required to honour this and may extend their review to both elements if they feel it is justified.
In the majority of cases the risk to the un-appealed component is low, but we do, perhaps once a week or slightly less get a post from someone who has had the un-appealed component reduced or removed, so the risk is most certainly not zero.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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