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Appeal against MR over enhanced daily living needs

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1 month 1 week ago #294289 by Baldy
My son suffers from Ehlers Danlos Syndrome. This is a genetic condition which affects the ability of the body to produce collagen, which in turn means that all the joints in the body are weak and very easily dislocate.

He has been permanently in a wheelchair for the past 5 years, as his knee joints cannot support the weight of his body.

This is a degenerative genetic condition. My son's ability to do things will only worsen over time.

When he was first assessed for PIP he was awarded the enhanced rate for daily living needs. Following a routine review, this has now been downgraded to the standard rate.

We have requested a mandatory reconsideration. This has come through, and the decision has not been changed.

We intend to go to appeal and I am seeking advice on what I should put forward as written submission prior to tribunal appeal.

His score was 9 points.

This was comprised of:

Preparing food: 4/8

Washing and Bathing: 3/8

Managing your toilet needs: 2/8


We are therefore 3 points short of the requirement for the standard rate to be upgraded to the enhanced rate.


The following is the wording we used on the mandatory reconsideration form, which resulted in no change. I would like your opinion and advice on whether the same wording is appropriate as written submission prior to appeal tribunal, and if not how it should be changed.

We are particularly surprised that the Preparing Food score was not adjusted, as we do not believe my son is at all able to prepare food and should have received the full 8/8 points, which would have been sufficient in itself to achieve the enhanced rate.

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I disagree with the assessment moving me from the Enhanced Rate for Daily Living to the Standard Rate, as I believe I would score over 12 points in a correct assessment.

Specifically, I believe the following factors have been scored incorrectly:

1. Preparing food - I received 4 points. I believe I should receive the full 8 points. I am entirely unable to prepare or cook a simple meal. I cannot reach a worktop in my wheelchair or stand to access one as I am permanently wheelchair bound. I am unable to handle hot or heavy items due to my unstable joints in my arms making it dangerous to myself or others. I am incapable of lifting a 1L carton full of liquid without danger of dislocation to my fingers or wrists.

2. Dressing/Undressing - I received 0 points. I believe I should receive at least some points due to the fact that when I am having a flare up of my condition (which can happen at any time), dressing can be difficult and painful, and requires help from my parents to put on clothing.

3. Mixing with other people - I have received a score of 0. I believe I should have some points allowed due to the following factors:

I have a diagnosis of Depression and Complex Post-Traumatic Stress Disorder (Evidence Enclosed). These impact on my ability to interact with other people without significant anxiety. I have sometimes avoided social events due to this.

4. Managing my Treatments - I have received a score of 0. I believe I should have more points due to the following factors:

Both my PTSD symptoms and fatigue/brain fog from Ehlers Danlos can result in involuntary episodes of altered conciousness which can cause significant reduction in awareness and concentration. Chronic Pain alsom makes concentration impossible. I have forgotten to take my medications many times because of this and require help and prompting from others to ensure medication is taken on a regular basis.

In the summary of the decision given on my PIP letter, there are two errors.

1. I have had a change to my pain medication since my last PIP assessment. My pain medication has been increased to include short-release Tramadol to be taken up to 4 times a day on the advice of an Ehlers Danlos specialist. (Evidence enclosed).

2. I am currently under the care of a private physiotherapist who specialises in Ehlers Danlost (Evidence enclosed).

Ehlers Danlos syndrome is a degenerative medical condition and my symptoms will not improve and are likely to worsen over time.

My father has helped me to fill this form.

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Thanks in advance for any comments and advice.

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1 month 1 week ago #294298 by Gary
Hi Baldy

Welcome to the forum.

You might want to have a look at the following FAQ which explains where everything is; www.benefitsandwork.co.uk/guides-for-claimants/faq/forum.

The first question I would ask you, have you requested a copy of the assessors report?

When you have the assessors report, you will have a better understanding of how the DWP Decision Maker has come to their conclusions and you will now be able to argue against them.

I usually use a highlighter to highlight any inaccuracies, once you have gone through the report you then set out why you are applying for a MR and go through each descriptor one at a time why you disagree with the assessor and try and match it with any supporting documents you may have sent in.

Understand that the assessor is offering an opinion when they say 'in my opinion' you can do the PIP activities, tackling these head-on is unlikely to be successful, you need to show that the basis of that opinion is founded on incorrect information, so try and refer to your evidence to undermine what they have said, remember they are just an opinion which is not based on fact.

Also, try and stick to issues that lead to your scoring points, I often hear members referring to the assessors spelling, as an example, whilst it may show a lack of professionalism, raising it as an issue isn't going to help you get an award.

Your primary task is to show that you meet the criteria, there are many reasons you may have failed, you need to address each of these but don't get bogged down in criticising the assessment report unless you can clearly show that it is incorrect, it is a lot easier to argue the facts of the situation.

Lastly, make sure that you understand the criteria that you are being assessed against you can put the best case forward that is possible but you won't score points if you do not meet the PIP Descriptors.

The first stage to challenging a Decision is for you to request a Mandatory Reconsideration, this you have already which has resulted in the same result. The next stage is to appeal the decision. You have one month from the date of the MR decision in which to do an in time appeal, the absolute time limit is 13 months with good cause in which to appeal, have a look at our PIP MR & Appeal guide; benefitsandwork.co.uk/guides-for-claimants/pip

Don't use grey words such as 'likely to worsen over time', when completing a form it should be in black and white.

Has there been a change in your son's condition from when previous assessed?

When you have a better idea of the issues with your claim, come back to the forum and we will do our best to help.

Gary

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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