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Managing Therapy
- G15GJC
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7 months 4 weeks ago #288771 by G15GJC
Managing Therapy was created by G15GJC
Hi all,
I have severe back problems which impact my mobility and am waiting an appointment with the Consultant regarding potential surgery.
I am seeking some advice for a potential appeal on the above daily living need. As part of my application I advised that due to my condition, I require assistance from my wife to undertake the exercises prescribed by my physio that takes no more than 3.5 hrs to 7hrs a week.
On the decision, I was awarded the standard rate however the DWP stated that managing my therapy takes no more than 3.5hrs and awarded 2points. This statement is incorrect as I stated 3.5hrs to 7hrs in my application and therefore expected to be awarded 4 points.
I requested a re-determination based on the above however the DWP have now awarded 0 points stating there is no supporting information that indicates I cannot complete my exercises independently. The redetermination also reduced the duration of my award by 1 year.
Again, this is incorrect as I provided information from both my GP and my Physio confirming my issues.
Even with the reduction to 0 points I still qualify for the standard rate however if scored 4 points as expected this would increase my award to enhanced.
My question is should I now move to an appeal based on the above or accept the decision and deal with the issue at my review stage?
Thanks in advance for any advice or guidance that can be offered.
G
I have severe back problems which impact my mobility and am waiting an appointment with the Consultant regarding potential surgery.
I am seeking some advice for a potential appeal on the above daily living need. As part of my application I advised that due to my condition, I require assistance from my wife to undertake the exercises prescribed by my physio that takes no more than 3.5 hrs to 7hrs a week.
On the decision, I was awarded the standard rate however the DWP stated that managing my therapy takes no more than 3.5hrs and awarded 2points. This statement is incorrect as I stated 3.5hrs to 7hrs in my application and therefore expected to be awarded 4 points.
I requested a re-determination based on the above however the DWP have now awarded 0 points stating there is no supporting information that indicates I cannot complete my exercises independently. The redetermination also reduced the duration of my award by 1 year.
Again, this is incorrect as I provided information from both my GP and my Physio confirming my issues.
Even with the reduction to 0 points I still qualify for the standard rate however if scored 4 points as expected this would increase my award to enhanced.
My question is should I now move to an appeal based on the above or accept the decision and deal with the issue at my review stage?
Thanks in advance for any advice or guidance that can be offered.
G
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- LL26
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7 months 4 weeks ago #288774 by LL26
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by LL26 on topic Managing Therapy
Hi G15GJC,
Welcome to the world of odd decisions!
If I understand correctly you have already asked for a Mandatory Reconsideration. Usually the next stage after MR is to appeal to the tribunal.
Just make sure that you have correctly calculated the 'time value' for therapy. It is the actual length of assistance required rather than the length if therapy that is important. Thus if the only daily help is say 5 minutes to get out equipment and then another 5 minutes at the end to clean it and put it away - here the amount of help is 5 minutes x2 per day x7, so this would only fall within the 'up to 3.5 hours' category, even though the actual exercises take 30 minutes each day. Obviously if for those 30 minutes eg physical support is needed, or your wife has to help bend your leg etc full the whole time, then in this example it will be 7 x 30 minutes plus time to get out equipment if you can't do this yourself.
If you wish to appeal
You need to fill out a SSCS1 form - but this can be done online.
In the Grounds of Appeal explain as you have above. Perhaps you can get a further statement from your physiotherapist, and perhaps from your wife. What exact help is required and why can't you do it yourself. Explain about the original decision and then the revised decision, both about the therapy and length of award. Send in the original statements etc again, and say in your Grounds of Appeal that you are resending as these statements were clearly ignored.
If you use the online form, it is usually better to type the Grounds as a separate Word document. Unfortunately the set up of the online form is that typing comes out as one long paragraph with no spaces, and it gets difficult to read!
It is entirely possible that the devision will be re-revised once you lodge the appeal. Otherwise you may need to go to a full hearing.
As you have unfortunately found out, awards can be reduced if you do appeal. However if you get to the tribunal a warning will at least be given, and you could withdraw.
I hope this helps.
LL26
Welcome to the world of odd decisions!
If I understand correctly you have already asked for a Mandatory Reconsideration. Usually the next stage after MR is to appeal to the tribunal.
Just make sure that you have correctly calculated the 'time value' for therapy. It is the actual length of assistance required rather than the length if therapy that is important. Thus if the only daily help is say 5 minutes to get out equipment and then another 5 minutes at the end to clean it and put it away - here the amount of help is 5 minutes x2 per day x7, so this would only fall within the 'up to 3.5 hours' category, even though the actual exercises take 30 minutes each day. Obviously if for those 30 minutes eg physical support is needed, or your wife has to help bend your leg etc full the whole time, then in this example it will be 7 x 30 minutes plus time to get out equipment if you can't do this yourself.
If you wish to appeal
You need to fill out a SSCS1 form - but this can be done online.
In the Grounds of Appeal explain as you have above. Perhaps you can get a further statement from your physiotherapist, and perhaps from your wife. What exact help is required and why can't you do it yourself. Explain about the original decision and then the revised decision, both about the therapy and length of award. Send in the original statements etc again, and say in your Grounds of Appeal that you are resending as these statements were clearly ignored.
If you use the online form, it is usually better to type the Grounds as a separate Word document. Unfortunately the set up of the online form is that typing comes out as one long paragraph with no spaces, and it gets difficult to read!
It is entirely possible that the devision will be re-revised once you lodge the appeal. Otherwise you may need to go to a full hearing.
As you have unfortunately found out, awards can be reduced if you do appeal. However if you get to the tribunal a warning will at least be given, and you could withdraw.
I hope this helps.
LL26
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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- G15GJC
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7 months 4 weeks ago #288786 by G15GJC
Replied by G15GJC on topic Managing Therapy
Thank you LL26,
The exercise plan prescribed by my Physio contains a number of different stretches and movements that are carried out either from a laying, seated and standing position. Due to my mobility issues I find the transition between the positions difficult and painful which is why I need the support of my wife.
As an example, If I am carrying out an exercise in a laying position, I need her to help me stand up from the ground so I can do the next exercise in a standing position.
The whole process to complete my exercises takes around 45min per day in total, spread over 3no. 15mins sessions. I understand your point in regards to time value and will check this however would state that if my wife is not present for the full duration then it is likely I would not be able to complete my full exercise plan as I would need to exclude those that require me to complete from a laying position as there is a risk I would not be able to stand back up.
Thanks again.
G
The exercise plan prescribed by my Physio contains a number of different stretches and movements that are carried out either from a laying, seated and standing position. Due to my mobility issues I find the transition between the positions difficult and painful which is why I need the support of my wife.
As an example, If I am carrying out an exercise in a laying position, I need her to help me stand up from the ground so I can do the next exercise in a standing position.
The whole process to complete my exercises takes around 45min per day in total, spread over 3no. 15mins sessions. I understand your point in regards to time value and will check this however would state that if my wife is not present for the full duration then it is likely I would not be able to complete my full exercise plan as I would need to exclude those that require me to complete from a laying position as there is a risk I would not be able to stand back up.
Thanks again.
G
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- Gordon
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7 months 3 weeks ago #288844 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic Managing Therapy
G
But how much of the 3 x 15 is she actually assisting you with the exercises rather than simply being present?
The DWP will argue that she is only assisting you when you need to stand up, using the example in your post, she could walk away and come back when she is needed again.
You need to find a credible way of showing that her assistance is required throughout the 15 session.
Gordon
But how much of the 3 x 15 is she actually assisting you with the exercises rather than simply being present?
The DWP will argue that she is only assisting you when you need to stand up, using the example in your post, she could walk away and come back when she is needed again.
You need to find a credible way of showing that her assistance is required throughout the 15 session.
Gordon
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