Pip claim for facial disfigurement

Hi Money123Money

I'm so sorry to hear of your sister's experience. I'm not surprised that she is reluctant to try again.

I hope that a member may have experience or have a family member who has been in a similar position who may be willing to share about their experience.

Here are some things you might want to consider.
1. Have you received the PA4 (the assessor's report)? This should give you more information about how the decision is reached. You need to understand why they didn't seem to place much emphasis on her mental health. If you haven't got it - then your sister needs to ring the DWP and ask for it - it takes 7 - 10 days to arrive (though sometimes it turns up sooner). However, your sister might need support to do this. Unless you have the right to speak for her - you won't be able to ring and make this request without her being able to give permission first.

2. Mandatory Reconsiderations are hard to win. Less than 30% are currently successful. That is not to say your sister shouldn't try if she wants to. The people who do win - always think it is worth it - as do the people who lose but then go on to win at Tribunal. The chances of winning a Tribunal are much better and I think the last figures were 67% are won by the claimants. I mention these figures only because your sister will have to consider her fragile mental state.

3. When your sister filled out her original form did you use our guides? If she didn't - I would have a look at the Guides to PIP claims and reviews and see if the information you gave was comprehensive enough. Sometimes claimants miss out just because they miss out information which would improve their chances of getting an award. It happens to thousands of people and this might include your sister. You say in your post that there are many ways she is affected - you need to know the PIP criteria and see if there are any other areas she could possibly score points, which perhaps she did not mention.

4. Don't get hung up on the fact that they can't see your sister's birthmark. I can understand why you are upset when you have tried to show the severity of her birthmark - but when someone has a telephone assessment, the assessor can't verify anything they are told visually. They have to take the claimant's word for their disabilites (Sometimes they do and sometimes they don't). I would focus on how her depression and anxiety affect her in line with the PIP criteria and not the cause. Please don't think I'm not taking the cause seriously - I can completely understand why she has difficulty leaving the house - but from the DWP point of view - it is the depression and anxiety that they will focus on. They will look at any medication and any therapy she might be having and any contact with mental health services past or present, and any contact with GP. Now, she may not have contact with services (plenty don't), but then you, as a family member, could add a letter (if you didn't previously)as you know the impact on her life as per the PIP criteria.

5. If your sister isn't currently in the right place to put in for an MR - she could always put in for a late one. She has 13 months from the date on the decision letter. However, they don't always accept late submissions, and you would have to argue that it was due to her poor mental state that she didn't do it within the first month. The other option is if you think that you didn't provide enough information the first time around, she could when she is ready, put in a new application at any time. I'm not saying that is a better option - it's just a different one.

6. I hope that whatever your sister decides to do - it is the right decision for her. I would like to say that it gets easier - but it doesn't. It's a horrible process that brings a lot of people to their knees - but if you can assure her that lots of people have been rejected and have fought through and eventually won. She's fortunate that she has you to support her because many have to do it entirely alone. However, the most important thing is her mental state and she can only do it when she feels able and if she wants to carry on.

Best of luck to both of you.

BIS

Hi Money123Money

Please never feel you failed your sister - you didn't, and you haven't. The fact that you are there to support her is a good thing. The system failed her as it does many people.

It's up to the two of you whether you decide to use the CAB. The majority of CAB members are wonderful and offer a great service but not everyone has a great experience. They are under a huge amount of pressure as the need for their services have risen and they can't always give the time to PIP applications that they would like or are needed and some people are then disappointed in the forms that are sent back as CAB workers sometimes think information is unnecessary that we believe is vital. They also won't ever be able to write the detailed application you have. Remember, no one knows your sister and her difficulties better than the two of you. I'm not saying don't use them because, as I said, there are some great and supportive workers, but don't assume that, in this case, they will do a better job than you. There are too many people who don't manage to get PIP awards that they should be entitled to because of the vagaries of the PIP system or some ignorant assessors and decision makers. Don't put it on you!

BIS