PIP discrimination regarding PIP and Medical Evidence

I've encountered an "unreasonable" decision regarding my PIP award.

In her Justifications the HA has stated a range of treatments that I am not recieving, and then concluded.........
"....suggesting aids should be sufficient in managing her fatigue" And that's exactly what she's done.
In every activity that I've scored points, she's awarded the "aids and appliances option".

She's even done so to the exrtent that in one activity it's entirely inappropriate for my condition.

I have evidenced to the DWP that i cannot provide futher evidence because I cannot access treatment. the DWP have attempted to suggest that this is indicative of a low level of disability.

There is a background to this. I have Chronic fatigue syndrome ( CFS sometimes known as ME)
The condition has a long history of being medically politicised, and there have been I think 5 Parliamentary hearings and recently a Ministerially led enquiry resulting in an interim report detailing the way forward for treatment; produced in December last year.

It is widely recognised that availability of health services for CFS/ME throughout the uk is sparse and missing altogether in many areas of the UK
The matter has been further complicated by the release in 2021 of the National Institute of Cinical Excellence (NICE) guidance which stipulates the requirement for clinicians providing health services to CFS patients to be "specialists".
What was intende to improve treatment for CFS patients has become a means of refusing requests for referral.

I have been refused 4 requests for referral into the NHS since 2017/18. some citing "lack of specialism"

I have evidenced this to the DWP, I have also provided a GPs letter confirming there is no treatment in this area.
I have included a response from my area Health Trust in response to a FOI request stating that there is "no treatment path for these patients. Patients will be managed at primary care Level".

As you are aware the DWP are empowered to disregard the evidence of a GP in statute. And they have done so with the letter from my GP above and stating that i have symptoms of severe CFS.

The only response that I have had from the DWP is to tell me that complaints about the Health Assessment must be referred to the providers - MAXIMUS.

Also they have changed the allocation for one activity attributed points in the "aid or appliance" option, as I pointed out that the selection was ridiculous, but they have only changed it to a more defensible selection (from their position),which allocates the same number of points. And are relying upon evidence form a second opinion of a HA which has in her conclusions stated what is appropriate for "her CFS", in confirming the original decision. the seond HA appears tohave unilaterally decided the level fo severit of my CFS, and also what activities are commensurate with it.....I've never so much as spoken to her.

The admisitration of PIP appears to me to be legally fuzzy and open to biased exploitation and sloopy procedure by the DWP. It MUST be challenged.

As far as I can ascertain, statute enables the DWP to deny or limit an award if there is a" failure" to provide evidence.

Whislt "legally", the DWP can apply the failed to provide principle, clearly I cannot provide what is not available and this is unjust.

There doesn't seem to be any case law related to this "unreasonable" application of the law.

I am in the process of appealing to a FTT, but that will not provide a remedy to this issue. I and others who fall foul of the DWPs method of interpreting the statute will continue to be subject to this discrimination. Indeed my PIP award is up for renewal in 2026.

I had thought that if I can somehow get the case referred to an Upper Tribunal, I could get some case law clarifying this matter. But on researching UT decisions the best that I am likely to achieve is a referral back to a FTT to re-hear the matter, and I have to find a POINT OF LAW on which I can reach the upper tribunal.

I don't feel I can let this administrative prejudice stand. But I can only raise about £4k, and from what I've read, a Judicial Review costs around £20k, and if lost I become liable to costs, which effectively means losing my very modest home.

This matter is probbly going to become much more prevalent, as the Govt have endorsed and financially incentivised Health Trusts to "rationalise" their waiting lists. they are empowered and incentivised to reduce waiting lists by not accepting and rejecting previously accepted referral requests; forcing patients back onto primary care - their GPs who as stated the DWP are empowered to ignore. In fact many Trusts have been doing this for some time.

This must be resolved and with some urgency. How can i proceed? Desparate for legal advice.

Many thanks Carol

Disability Rights UK is worth a look.
The whole system is a mess.
There have been multiple court cases.
There is a procedure to follow to challenge decisions.
You can sometimes get help from CAB.
Fightback is worth a google, but you have to pay; but considerably less than a lawyer.
Most people on this site have experienced this already.
Maybe read some forum posts.
You are not alone. This is incredibly commonplace.

This is a really well thought out response.
I have cfs/me for 25 years. Eventually I got enhanced/enhanced with 10 year light touch. I’ve been quite lucky with the assessors but I really think it’s pot luck sometimes, but the good news is you have several goes at getting it put right. You won’t find better guides that from benefit and work, I’ve used them in all my applications and renewals. People often with nil points get overturned to maximum, but I suspect complaining about the assesor is a lost cause, as it’s always difficult to fight an opinion. Good luck from a fellow sufferer.