PIP Mandatory Reconsideration Letter Advice (scored 0 across the board)

Hello,

I suffer from ADHD, anxiety (general & Social), dyslexia and dyspraxia and i have recently received my PIP decision notice and i'm so disheartened and upset to see I scored zero across the board. The reasons given bare no relation to my struggles at all.
I recently made a post asking if it would be okay to post the letter i have written to accompany my mandatory reconsideration to get feedback from the forum. A Mod confirmed this would be okay so I've posted it below. I have been waiting for my further evidence to arrive before sending over my letter. I rang the DWP within the 30 day period to let them know i would like MR and that i'm waiting on further evidence so my paper request will technically come in after the 30 day period.

I've never done anything like this before so i'm not sure exactly the best angle to tackle it from or what is appropriate to say so any input is greatly appreciated. i'm very glad that this forum allows you to be anonymous as its so nerve wracking revealing all and being so vulnerable.

Thanks in advance!

Original post: www.benefitsandwork.co.uk/kunena/10-dla-...d-0-across-the-board

_________________________

Dear Sir/Ms
MANDATORY RECONSIDERATION REQUEST

I request that you reconsider your decision dated 27th October 2023.
I believe that between my initial application and new evidence now attached that I provided enough evidence for a decision to be made that I am entitled to PIP at the rate of enhanced for daily living and standard for mobility.

The zero scores across the board and justifications given by the decision maker in their report show a lack of understanding of what it is like to live with mental health conditions such as ADHD and Anxiety.

The following extract is taken from notice of decision:
‘Whilst it is acknowledged you have specialist input, an active referral for therapy and medication consistent with ADHD, there are no visitation or clinic appointments with a crisis mental health team, community psychiatric nurse’ further along the report this statement is repeated with the following added to the end “and there are no active therapies”.

Using the amount and type of treatment received as an indication of severity for mental health issues is deeply flawed, as these very same issues can make it extremely difficult to get help in the first place, and the level of help available very much depends on what services are available in your area. The above statement suggests that DWP have acknowledged that I struggle with mental health conditions, that if effects my daily life and that I have taken the steps available to me to seek some help, the fact that I’m not currently suicidal means that further help isn’t justified.

I personally find it extremely difficult to reach out for help as I find the idea of speaking to someone about my problems extremely intimidating, and often struggle to express exactly what the problem is.

Regarding the point ‘no active therapies’, the wait list for mental health support in the UK is at an all-time high, so to penalize someone reaching out for support, both therapy wise and in terms of benefit support seems counter-intuitive. I’m currently seeking support for symptoms relating to my ADHD, social anxiety, general anxiety, and dyspraxia. Whilst on the waitlist for 1 on 1 support, I was enrolled in an online mental health program for anxiety and depression (SilverCloud) to help bridge the gap. – evidence of this attached. My formal therapy sessions started 22/11/2023.

Guidance for PIP assessment state If there is evidence that someone is awaiting treatment or further intervention HPs should take into account the facts and likely impact of that future treatment regime as they are evidenced at the date of the assessment, as part of their consideration of whether the person will meet the prospective part of the required period condition. Just because I didn’t currently have full access to all the support I need to cope, it doesn’t mean that I don’t need it.

Since my initial claim, this therapy has now started, and I have had my first 2 sessions. I have attached a copy of my records as evidence of treatment and further evidence of my symptoms.
Further in the report it states:

“During your assessment you were observed to have good speech, cognition, intellect, memory function and did not appear to require support or prompting”.

The assessment over the phone, which doesn’t allow for the assessor to see constant fighting, nervous bone cracking, racing through my notes, no eye contact, dry mouth, sweating palms and a racing heartbeat. All physical symptoms of anxiety. What the phone does allow for, is for me to pause before speaking, take a little time to compose myself to try and ease a nervous stutter, in order to get through a very nerve wracking and gruelling phone call. For this reason, when choosing between telephone and face to face, a telephone assessment would always be my preference. A face-to-face assessment and the journey involved in such, would cause overwhelming psychological distress.

Regarding the ‘memory function’, ADHD has been proven to cause problems with working memory. This is the part of your memory that allows you to turn information you learn into action, for example: remembering instructions long enough to finish a task. A 45-minute phone call isn’t enough to state that I have ‘good memory function’ when my evidence (missed appointments, forgetting things, lost items, leaving the cooker on) all suggest otherwise.

Using the point of intellect as justification for not needing support is an outdated way of thinking. Whilst seeking my Dyslexia diagnosis growing up, I was refused assessment time and time again as I had ‘intelligence’, but the intelligence didn’t mean that I didn’t need support for my difficulties reading and writing.

I have made the following bullet points to directly challenge points within the report.
1. Preparing Food – The Assessor chose a. Can prepare and cook a simple meal unaided.

I believe I qualify for e. Needs supervision or assistance to either prepare or cook a simple meal. (4)
The reasons for this are:
• My ADHD means I lack motivation to prepare food. Meaning without a prompt from someone I won’t undertake this task.
• My ADHD also means I get distracted, and this causes me to lose track of time, leading to burnt and bad quality food. This also leads me to leave the oven or the hob on unless I’m prompted by a partner or friend to check. It is not uncommon for me to boil pans dry or forget to switch things off. Therefore, I cannot do this safely without supervision or assistance.
• I get overwhelmed when attempting to cook alone as there is so much going on, it amplifies my trouble with my hands, and hand eye co-ordination and I drop food, utensils and pots.
• I have always lived with either a parent or a partner and relied on those people for support and encouragement to cook a proper meal. Now that I no longer have this support or someone to prompt me daily, I will stick to ready meals or convenience food such as super noodles.
• The above difficulties provide clear evidence that I cannot prepare and cook a simple meal to an acceptable standard safely and repeatably alone.

2. Taking nutrition – The Assessor chose a. Can take nutrition unaided.

I believe I qualify for d. Needs prompting to be able to take nutrition. (4)
The reasons for this are:
• Without being prompted by a partner or friend, I often don’t drink liquid all day as I forget to drink. When I remember or feel physically thirsty, I put it off until I have finished what I’ve hyper focused on or come out of an ADHD Paralysis which can often be an hour or so later.
• The same point above applies to my ability consume nutritional food. When I do eat a meal unprompted or supervised, the food I eat is low in nutritional value, i.e ready meals or convenience food.
• Due to my personal circumstances, I only have someone with me 2-3 days a week, meaning that I spend more of the week alone than I do with someone.
• My inability to prepare a nutritional meal causes me to either not eat anything at all as I just forget or put it off unless I have someone with me.
• On a particularly bad anxiety day, I can feel so anxious it makes me nauseous and completely knocks my appetite.
• The above difficulties provide clear evidence that when supervised once or twice a week I can take nutrition, however for the majority of the time I cannot take adequate nutrition repeatably alone.

3. Managing therapy or monitoring a health condition – The Assessor chose a. can manage medication or therapy or monitor a health condition unaided or do not need to.

I believe I qualify for c. Needs supervision, prompting or assistance to be able to manage therapy that takes no more than 3.5 hours a week. (2)
The reasons for this are:
• I forget to take my medication all the time. I have a reminder (aid) set up on my phone. This helps a lot of the time, but I still very often forget.
• My partner prompts me to take my medication.
• I forget to order my repeat prescription and have multiple reminding aids set on calendars and receive prompts from my partner.
• This has been a part of my life now for a while now, and due to my ADHD and forgetful tendencies I have been unable to engrain this as a routine and still struggle to remember.
• Without the aid and the prompts, I don’t take my medication and without my medication my symptoms are massive heightened, and I cannot properly function.
• Recent national shortages of my medication have led to me being forced to take medication breaks. It has also led to a change in how my dosage has been made up. E.g I take 50mg daily but have been prescribed 1x20mg and 1x30mg. Without supervision I have mixed those dosages on two occasions now have accidently taken 2x50mg tablets in one sitting, and not realised until I’ve not slept that night.
• The above difficulties provide clear evidence that I cannot manage my therapy to safely and repeatably without supervision or prompt.

4. Washing and bathing – The Assessor chose a. Can wash and bathe unaided.
• Whilst I agree I can shower and bathe unaided, I regularly avoid doing so without nagging and prodding from a partner or put it off until the very last minute. ADHD procrastination results in me needing reminding to start or continue washing.
• I suffer from ADHD burn out which makes me feel physically and mentally exhausted and I cannot bring myself to get up and get cleaned.
• When in the shower I am impatient and just want it to be over, so I’m encouraged by my partner to make sure I have completed all the steps in order.

5. Managing toilet needs or incontinence – The Assessor chose a. Can manage toilet needs of incontinence unaided. I agree with this point.

6. Dressing and undressing – The Assessor chose a. Can dress and undress unaided.

I believe I qualify for c. (ii) Needs prompting or assistance to be able to select appropriate clothing. (2)
The reasons for this are:
• whilst I am physically able to put clothing on, I lose track of how long I have been wearing the same clothes and fail to notice when they are in need of cleaning. After wearing I tend to throw clothes in a pile on the floor and then just work from the pile. Until I’ve been asked when the last time that something was washed was and encouraged to wash, I don’t tend to wash my clothing. Un-clean clothing is not appropriate clothing.
• Anxiety issues around my body image make me stick to wearing the same few select clothing items, which makes the pool of clean clothes to choose from significantly smaller.
• My partner has started to come and do washing with me once a week as a mechanism to try and prevent this from happening. Without this encouragement my clothes would go unwashed long periods of time.
• Some days I will feel so low or exhausted from being burnt out that I don’t have the physical or mental capacity to bring myself to get dressed. On these days if my partner doesn’t come round to visit, I just won’t get dressed.
• Because of my impulsive nature and poor time management, I often just grab whatever clothing is nearest, regardless of if it is clean or for example if I grab a jumper first, I don’t take into consideration that I maybe to hot later.

7. Communicating verbally – The Assessor chose a. Can express and understand verbal information unaided.

I believe I qualify for c. Needs communication support to be able to express or understand complex verbal information.
The reasons for this are:
• I’m anxious to engage in verbal conversations as I struggle to understand social cues. my ADHD makes me constantly interrupt, meaning that I’m thinking about what I want to say and not what the person has said to me.
• Afterwards this leads to me feeling anxious about how the conversation went down and as I result, I try to avoid engaging in those kinds of encounters again.
• My ADHD causes poor working memory for things that have been said to me, especially when already stressed and I miss things that people have said to me and often have to ask people to repeat information. This causes a lot of embarrassment. If I’m in a situation here I know I will need to retain important information I will need someone with me for support or as a ‘second pair of ears’.
• I find speaking to people outside of those that know me very well to be something that generates a lot of anxiety. The point was made in my PIP decision that I work full time in a role that requires adequate level of cognitive ability. The report however doesn’t take into account the fact that I have worked at my current workplace for nearly 10 years, and in doing so have been able to become comfortable with the people around me, meaning that I have been able to adapt my work environment to feel more comfortable and ease my anxiety in the working day. The same can’t be said for encounters outside of this environment.
• Using my PIP telephone assessment as an example. I had time to prepare, make notes have everything I needed easily accessible to try and not miss any important information and to get my point across. In day-to-day life, I don’t have that luxury and this lack of available resource causes a lot of anxiety and stress for me.
• These are mental health issues that I’ve felt so strongly about I have sought out the help and support of professionals; therapists and psychiatrists to try and help to learn to cope. These are all points I have spoken to therapists about in the past, and points that I will continue to discuss in CBT. These continue to be daily issues in my life hence my on-going therapy, referrals and support. Evidence of this is seen in my attached medical records.
• I cannot properly convey my emotions or feelings, and this can make me act out of term in frustration.
• My social anxiety heightens the speech issues related to my conditions causing me to stutter and mix words up when trying to communicate with people. This is distressing and embarrassing. Having a person with me for support allows me to ease my anxiety somewhat, and in turn reduce the speech issues.
• The above difficulties, along with my supporting documents provide clear evidence that I cannot express or understand complex verbal information without support provided from other people and professionals.

8. Reading and understanding signs, symbols, and words – The Assessor chose a. Can read and understand complex written information either unaided or using spectacles or contact lenses.

I believe I qualify for b. Needs to use an aid or appliance, other than spectacles or contact lenses, to be able to read or understand either basic or complex written information. (2)
The reasons are:
• I require an overlay to help with my reading and will often use text to speech. The assessor has agreed with this point in the report and stated that I do need an aid to manage this activity but did not correctly award points for this.
• It takes me twice as long to read a sentence or short piece of text than someone without ADHD or dyslexia because of difficulties with visual processing, language processing, short-term working memory, or concentration. For longer pieces of text, I will ask someone to read them to me or use a text to speech.
• As I struggle with reading due to dyslexia and having poor concentration, it feels tedious to me, and I often ‘switch off’ before I have got the point of what I’m trying to read.

9. Engaging with others face to face – the assessor chose a. Can engage with other people unaided.

I believe I qualify for c. Needs social support to be able to engage with other people. (4)
The reasons for this are:
• I don’t feel comfortable mixing with new people without a ‘safety blanket’ or ‘safe person’ usually in the form of a friend or partner.
• I’m anxious to engage in conversations with people I don’t know or who don’t know me as I struggle to understand social cues. my ADHD and anxiety create an endless loop of overcompensating for being anxious and coming across to strong, which leaves me with massive social anxiety afterwards or causing me to go into a situation far to quiet and reserved and not getting the desired outcome from an encounter.
• I have difficulties being part of a big group of people and knowing the right time for me to be involved. This makes group settings a very anxious experience for me, and I need someone close to me to be there for support.
• These are mental health issues that I’ve felt so strongly about, I have sought out the help and support of therapists and psychiatrists to try and help to learn to cope. These are all points I have spoken to therapists about in the past, and points that I will continue to discuss in CBT. These continue to be daily issues in my life hence my on-going therapy and support.
• I struggle massively with in person eye contact and fidgeting when trying to have a face-to-face conversation with someone. This worries me for the whole conversation as I think that the person I’m speaking to won’t think I’m listening, which in turn leads to me not listening and as a result I’ve missed vital points of the conversation.
• My ADHD can cause me to burn out and makes me short tempered and impatient, and this leads to me snapping at people around me. I cannot regulate these emotions and need support from people to rationalise and calm down.
• My heightened sensory issues mean that I cannot effectively communicate with people in environments with either too much, or particularly triggering background noise. If there is someone tapping or whistling, I can’t concentrate on what the conversation is about.
• I am better at engaging with people online or over text as it means I don’t have to deal with the immediate response needed with face-to-face engagement. Messages give me an opportunity to read them multiple times and think about how I want to respond and reduces my in person impulsive nature. It also allows me to hide my anxious tendencies behind a screen.
• The above difficulties along with my supporting documents provide clear evidence that I cannot effectively or reliably engage with people without support provided from other people and professionals.
10. Making Budgeting decisions – The Assessor chose a. Can manage complex budgeting decisions unaided.

I believe I qualify for b. Needs prompting or assistance to be able to make complex budgeting decisions. (2)
The reasons for this are:
• I am impulsive and often hyper fixate on things or new hobbies that consume my every thought. This leads to me being able to justify spending money on things that realistically I don’t have and can’t afford. I need a partner or family to rain me in and try and remind me what smart financial decisions are.
• I can easily lose track of what has happened financially, because money goes in, and just comes out I can’t keep track of how much things have cost me or how much expendable cash I’ve got.
• I have my partner review my finances with me and help me work out what money I need to have where and at what times to try and avoid getting into a difficult financial situation. He will check my outgoings and in goings.
• I carry a massive amount of shame and anxiety around having a poor financial situation and it makes it hard and embarrassing to seek out help. Even though I have asked for help, this wasn’t easy and is something that really affects me.
• I avoid going shopping on my own as I find the shops overwhelming and also tend to make poor financial decisions and impulsively buy things that I don’t need or can’t afford.
• I’m unable to plan ahead for big purchases or bills that I may incur. For example, I need help from someone to work out how much money I will need to put aside for insurance, bills or big purchase and make me a plan to try and stick to. I’m usually unable to stick to this plan and end up with drawing this money and spending on other things but without the support I wouldn’t have had part of the save in the first place.
Mobility Activities
11. Planning and following journeys – The Assessor chose a. Can plan and follow the route of a journey unaided.
I believe I qualify for either d. Cannot follow the route of an unfamiliar journey without another person, assistance dog or orientation aid. (10)
The reasons for this are:
• My dyspraxia and ADHD mean I cannot reliably remember my left and right, and as a result regularly end up going the wrong way. On a particularly bad or stressful day, this symptom is heightened. This leads to journeys taking me longer or me getting lost which causes significant stress. As a result of this, I do no undertake unfamiliar journeys alone as I’m to anxious and think that something is going to go wrong. The stress is so great it causes physical anxiety symptoms like racing heart and sweaty palms, not just psychological.
• Hyper focusing on the road and my condition related forgetfulness means I miss turnings on my intended route and having someone with me for support helps to mitigate this risk.
• My ADHD causes poor time management and I’m not able to plan and prioritise how to get somewhere reliably on time.
• The point was made in my PIP report that I drive a manual car, this is incorrect, my car is automatic. I chose an automatic car as I wanted to make driving as easy as possible.
• My Inability to focus means I might make mistakes when planning a route and would need someone else to help check that I’ve planned it correctly.
• I have a low sense of danger, poor concentration and move around impulsively and can often step out in front of other people, cars or bikes when walking out and about.
• Leading up to taking a non-familiar journey causes a lot of psychological distress for me and I need support and reassurance that everything will be okay.
• The report also stated that I drive a car to work, and I go to the shop. These are familiar journeys for me. However, although I can drive a car to the shop, I avoid going shopping on my own as its overwhelming and I make poor decisions.
• If I was to be lost in an unfamiliar place, I would struggle to pluck up the courage to ask for directions or help as I would be to anxious. Had I managed to ask for help, my adhd would make it hard for me retain the instructions.
• I struggle to read instructions and directions on how to get places and will skip ahead, miss important words or steps.
• My ADHD causes me to regularly miss important appointments (dentist, doctors hospital etc). I try to arrange for someone to accompany me to these appointments to try and avoid this happening.
I recently missed a dental appointment, and now found myself to anxious to remake the appointment because I was worried about the consequences of missing it and the possibility of it happening again. I needed my partner to remake the appointment and accompany me.
• A friend or partners would need to make a journey that involved public transport networks such as trains with me. Due to the unreliability, cancelations, strikes etc I wouldn’t be able to cope with a last-minute change and would be distressed.
12. Moving around – The Assessor chose a. Can stand and then move for more than 200 metres, either aided or unaided. I agree that this is the case.

Important note: should I wish to withdraw this request I will only do so in writing. Under no circumstances will I withdraw this request verbally. If you speak to me on the telephone about this matter, nothing I say should be construed as a withdrawal unless and until it is confirmed in writing.
Yours faithfully,