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PIP Decision
- Nellie-B
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2 days 5 hours ago #309853 by Nellie-B
PIP Decision was created by Nellie-B
Hiya, I'll try to make it brief as this has & still is consuming me. I was in a serious car accident in 1997, I was unalive after smashing head first into the windscreen from the back seat. I suffered multiple skull fractures, brain bleeds and amongst many other things my brain was shaken loose from the lining of my skull. After neuro rehab where I learnt to stand again I started a tedious journey. I still have awful memory issues, unregulated emotions, hallucinations, confusion, bipolar to name but a few. I have been under the care of the psychiatric unit ever since which treats the unregulated conditions with various psychiatric meds inc mood stabilisers. This helps to a degree but the long term brain damage which is scattered all the way through from the front to back of my brain causing weird and wonderful symptoms which dont have an actual diagnosis as such. The primary diagnosis from the hospital is 'Mental Disorders due to brain damage and dysfunction, followed by a second primary diagnosis of Mood Affective Disorder (Bipolar). I couldn't work from 1997 onwards so back then got Incapacity Benefit & DLA. When Incapacity benefit changed to ESA I was assessed at home and found fit to work, I was pretty poorly and didnt understand I could appeal or dispute so with 5 days notice of benefits stopping I spent almost 10 years trying to work making myself even more of a mess than I already was. I still received DLA through this time, it then changed over to PIP which I carried on receiving so this type of benefit had been constant. 2 or 3 years ago things eventually took a turn for the worse and it took until December last year to be awarded LCWRA of Universal Credit. I was shocked at how amazing the assessor was, he opened with 'dont worry just looking at what is going on with you we would never suggest anyone with injuries like yours should be expected to work' I'm sure he said he was a G.P or doctor of sorts and was interested in the injuries and what happened to me He apologised for the time I was found fit to work as it should never have happened. Anyway it gave me hope as my PIP review forms went in at the same time last year. What a difference oh my word, ultimately the decision letter awarded me 2 points in total for help with mixing with others. It states 'after reviewing medical evidence I decided to change the descriptors, you weren't to know they would be changed and we wouldn't expect you to know. It then listed briefly everything id said were issues with no comment either way and it was summed up with so as your condition has changed I cannot award you PIP. I was stunned especially as I had alot of help with it from The Brain Injury Charity. I requested Mamdatory Reconsideration and with alot of help from my family we have sent pretty much a whole new but very clear & precise version of the original form. I have even sent a 2nd copy of the diagnosis circled in red just in case they missed it or didnt understand the technical term as it had a code attached. I am totally defeated at this point and very very broke moneywise and am living on crippling anxiety since the forms went in originally in September 2024. I have searched the Internet for what they could possibly mean by changing the descriptors based on medical evidence and that I wouldn't have ever been privy to that information. I cant understand how they concluded my condition has changed to the point I dont qualify when far more is a struggle than it was in the early days. I was wondering if anyone has any idea what this descriptor change means and also how it can be changed as it would seem only fair that it stays the same for everyone across the board. Thanks
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- LL26
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12 hours 29 minutes ago #309930 by LL26
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by LL26 on topic PIP Decision
Hi Nellie-B,
I'm sorry to hear that you have a difficult time, especially with your PIP review. Hopefully your MR letter will do the trick, if not I have provided advice on the next stage just in case.
I'll try and unpick a few things.
Firstly the comment ' based on medical evidence' seems to be shorthand for based on the assessment. (I have seen this comment many times!)
The most important thing you can do is to phone up DWP on the PIP number and ask for a copy of the assessment report. I'm not sure if you had a meeting for this either phone or in person. If so you need to ask for PA4. If you didn't have a review in person an some sort of paper review occurred then it's PA3. You are entitled to the report, if you get fobbed off hang up and redial to hopefully get a better DWP advisor! It's very likely that the assessor has incorrectly written down what you have said. (And if the review was paper you obviously didn't say anything!) If you have already done this them that's great.
This is a Supersession case. (Assuming your award was still in place at the time of if decision.) Supersession is the legal word for when a decision in place is changed. If my assumption is correct then DWP will need to show an actual change of circumstances has taken place. The legal grounds for making a Supersession are quite complicated, but in brief (for your case) receipt of an assessment report can amount to receiving new medical evidence, which is one of the grounds ALLOWING a Supersession. However, it is a 2 part process 1. Legal reason to supersede 2. Actual evidence. In addition there has to be a correct effective date. From what you have said this should be either the date of the report or maybe decision date ie a few days later. Any other date would require evidence that your disabilities improved on some other date and there would need to be proof of something happening on that date.
You have reported disability for many years, and therefore it seems remarkable that DWP or rather the assessor has decided you have been remarkably cured!
Getting info from a relevant charity is exactly what I would do. This will confirm symptoms and explain the longevity of disability. If you have medical evidence eg GP report that's good too. If not statements from friends or cares who help you are also important. Similarly a prescription sheet showing eg increased meds or dosage will show worsening health. (And of course continuing meds will indicate your health problems are also continuing.) If you haven't sent these things you could send them in now - maybe phone DWP to say further evidence is being sent and ask for their MR decision to await this. You may be too late but don't worry.
If you don't get the same rate as before (decrease or nil award) then you will need to appeal.
Then you will need to fill out an SSCS1 firm which can be done online. Just Google 'online SSCS1'. Just be aware that there is a weird formatting glitch whereby anything typed in the boxes comes out as one huge paragraph with no gaps. Ok if it's just a sentence but nightmare to read loads of paragraphs! In this case, type out the Grounds of Appeal and attach as separate document.
Go through the assessment report. Work out 4 or 5 bullet points that explain the major flaws with it. Provide examples of the worst things.
Don't call the assessor a liar. It's unlikely you can prove this. However you can say he misunderstood or appears to have misheard. If the assessor constantly interrupted, was rude etc this can be one of your bullet points. Equally if the report has loads of grammatical mistakes and is poorly written this can indicate general lack of attention. Don't nit pick as then your important criticisms will get lost.
Grounds of Appeal - start off by explaining (if correct) that this is a Supersession. Then give a background to your health. Any treatment, medicine increases etc. Next write out the bullet points and examples. Finally got through each relevant description and compare points. What was awarded last time ( bearing in mind you may now qualify for more points) and what should have been awarded now, compared with what DWP awarded now. Assuming your points were correct last time then if no deterioration you should get the same points. Say so! Then you can confirm the problems you have saying eg I need supervision to cook and prepare food because...state what the correct points value should get, including any increase via worsening health. You may wish to revisit the members guides to go through each descriptor.
This is also how I would write an MR letter. You can send in a revised letter for MR to include any of these matters.
Remember to send in any medical reports etc too.
I hope that this helps and fingers crossed you won't need to appeal. Let us know how you get on.
LL26
I'm sorry to hear that you have a difficult time, especially with your PIP review. Hopefully your MR letter will do the trick, if not I have provided advice on the next stage just in case.
I'll try and unpick a few things.
Firstly the comment ' based on medical evidence' seems to be shorthand for based on the assessment. (I have seen this comment many times!)
The most important thing you can do is to phone up DWP on the PIP number and ask for a copy of the assessment report. I'm not sure if you had a meeting for this either phone or in person. If so you need to ask for PA4. If you didn't have a review in person an some sort of paper review occurred then it's PA3. You are entitled to the report, if you get fobbed off hang up and redial to hopefully get a better DWP advisor! It's very likely that the assessor has incorrectly written down what you have said. (And if the review was paper you obviously didn't say anything!) If you have already done this them that's great.
This is a Supersession case. (Assuming your award was still in place at the time of if decision.) Supersession is the legal word for when a decision in place is changed. If my assumption is correct then DWP will need to show an actual change of circumstances has taken place. The legal grounds for making a Supersession are quite complicated, but in brief (for your case) receipt of an assessment report can amount to receiving new medical evidence, which is one of the grounds ALLOWING a Supersession. However, it is a 2 part process 1. Legal reason to supersede 2. Actual evidence. In addition there has to be a correct effective date. From what you have said this should be either the date of the report or maybe decision date ie a few days later. Any other date would require evidence that your disabilities improved on some other date and there would need to be proof of something happening on that date.
You have reported disability for many years, and therefore it seems remarkable that DWP or rather the assessor has decided you have been remarkably cured!
Getting info from a relevant charity is exactly what I would do. This will confirm symptoms and explain the longevity of disability. If you have medical evidence eg GP report that's good too. If not statements from friends or cares who help you are also important. Similarly a prescription sheet showing eg increased meds or dosage will show worsening health. (And of course continuing meds will indicate your health problems are also continuing.) If you haven't sent these things you could send them in now - maybe phone DWP to say further evidence is being sent and ask for their MR decision to await this. You may be too late but don't worry.
If you don't get the same rate as before (decrease or nil award) then you will need to appeal.
Then you will need to fill out an SSCS1 firm which can be done online. Just Google 'online SSCS1'. Just be aware that there is a weird formatting glitch whereby anything typed in the boxes comes out as one huge paragraph with no gaps. Ok if it's just a sentence but nightmare to read loads of paragraphs! In this case, type out the Grounds of Appeal and attach as separate document.
Go through the assessment report. Work out 4 or 5 bullet points that explain the major flaws with it. Provide examples of the worst things.
Don't call the assessor a liar. It's unlikely you can prove this. However you can say he misunderstood or appears to have misheard. If the assessor constantly interrupted, was rude etc this can be one of your bullet points. Equally if the report has loads of grammatical mistakes and is poorly written this can indicate general lack of attention. Don't nit pick as then your important criticisms will get lost.
Grounds of Appeal - start off by explaining (if correct) that this is a Supersession. Then give a background to your health. Any treatment, medicine increases etc. Next write out the bullet points and examples. Finally got through each relevant description and compare points. What was awarded last time ( bearing in mind you may now qualify for more points) and what should have been awarded now, compared with what DWP awarded now. Assuming your points were correct last time then if no deterioration you should get the same points. Say so! Then you can confirm the problems you have saying eg I need supervision to cook and prepare food because...state what the correct points value should get, including any increase via worsening health. You may wish to revisit the members guides to go through each descriptor.
This is also how I would write an MR letter. You can send in a revised letter for MR to include any of these matters.
Remember to send in any medical reports etc too.
I hope that this helps and fingers crossed you won't need to appeal. Let us know how you get on.
LL26
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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