PIP Reviews: Case managers extending awards

Hi BIS

Thank you for your prompt response.

Andrew, the DWP PIP Appeals Case Manager, just called me and was being particularly friendly so I took the time calmly and concisely to set out my reasons and evidence for justifying a decision for an ongoing award over 10 years with light touch review. I had some notes to follow I had prepared in advance of the call. Andrew actually listened and agreed with me and said he will update my claim accordingly with an ongoing award and send a letter to confirm the change. He acknowledge the stress and harm it could cause me to progress to a hearing and how he wanted to avoid that scenario.

May this be an example that claimants can advocate for themselves and negotiate a decision before progressing to an appeal hearing.

Best wishes

Nicholas

Thank you for your response.

The DWP PIP Appeals Case Manager, called me today to find out if I was going to accept his offer to increase my award by a few years and withdraw my tribunal appeal. I took the time to set out my reasons and evidence calmly and concisely for justifying a decision for an ongoing award over 10 years with a light touch review. I had prepared notes in advance to reference during the call which included citing the DWP’s Advice for Decision Makers PIP Assessment Guide. The Case Manager actually listened and agreed with me and said he will update my claim accordingly and send a letter to confirm the change to an ongoing award. He acknowledged the unnecessary stress and harm it could cause me to progress to a hearing.

What a result!

This is a demonstration to claimants that you can be your own advocate and with some preparation you can negotiate with the DWP to secure the outcome you need without progressing to a tribunal hearing.

If you are happy with the points awarded to you but would like to extend the length of your award, it is possible to request a extension including moving to on-going award of 10 years with a light touch review. This request can be made following your initial claim assessment, a review of your claim, or as a request for reassessment that you initiate.

Please consider the following before pursuing a review of your most recent claim decision.

1. Are your conditions and how they affect your functional ability expected to remain the same in the long-term?

2. Do you have a healthcare professional willing to write you a letter advising the DWP that your level of impairment is not expected to change in the long-term and has a substantial impact on your functional ability?

If you can answer yes to the above two questions, then you have grounds to pursue a request to amend and extend the length of your award.

If you have recently had a decision on your claim, you need to first request a Mandatory Reconsideration (MR) asking to specifically review the decision on the grounds of the length of the award. State you are seeking an ongoing award due to your conditions and how they affect you being expected to remain the same in the long-term. It is important to clearly state you agree with the points awarded to you so the review focuses on the length of award.

If the MR fails which is often the case, your next step is to lodge an appeal with HM Courts and Tribunals Service online - www.gov.uk/appeal-benefit-decision/submit-appeal

Below is a template you can customise to your personal circumstances to use at the MR and appeal stages.

Your name - National Insurance Number XXXXXXXXX

Mandatory Reconsideration / PIP Appeal

What you disagree with
Appropriateness of a fixed term award - refusal to make an ongoing award

Why you disagree with it
PIP has [consistently] been awarded to me at the [standard / enhanced] rate(s) for [daily living / mobility / failing living and mobility] since the start of my claim in XXXX.

My disabilities include [physical / mental / physical and mental] impairments and chronic health conditions [insert your conditions here] that have a substantial and long-term adverse effect on my ability to carry out normal day-to-day activities as indicated in my [initial PIP claim form / subsequent responses to AR1 forms] and medical evidence provided.

Department of Work and Pensions guidance ‘ADM Chapter P2: Assessment for PIP’ states in P2062: Where following an assessment consultation, it is considered that the claimant has 1. a level of functional ability which is not likely to change in the long-term or 2. high levels of functional impairment which are only likely to increase a fixed term award will be inappropriate and an on-going award with a PIP Award Review date after 10 years will be applicable.

Several of my disabilities and chronic health conditions have persisted [since childhood and/or for most of my adult life] and will persist for the rest of my life. Limitations on my daily living and mobility have remained significant over time and are not expected to change materially in the future. This is the view of my healthcare professionals. Please see attached letter from [name of your healthcare professional providing evidence letter].

Therefore, as no material change in my limitations is expected, and in consideration of DWP published guidance and case law (RS vs Secretary of State Work and Pensions [2016] UKUT85 (AAC) Case Number UK/5459/2014), the only reasonable decision is that a fixed-term award in my case would be inappropriate and an on-going award should be applicable.

Thank you for your time and consideration.

Yours sincerely


Your name

It is highly likely the DWP Case Manager assigned to your request will try to offer you an extension of a few additional years especially if you have lodged an appeal following a failed MR request. It is up to you if you decide this offer is acceptable or not. You have the right to tell them on the phone you need a few days to consider the offer. If you decline their offer, then your case progresses to an appeal. Be prepared for this call and have notes saved on your mobile or on paper you can refer to summarising a few points to make it clear how your disabilities and health conditions have affected you over time without improvements and therefore will affect you in the future without the chance of improvement. It is important to be polite and also assertive when talking about your personal circumstances so the case manager can hear what you have to say.

Good luck!