Has anyone successfully appealed against a PIP decision for depression / anxiety

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I have been unable to work for the past 18 months after becoming depressed in 2010. I had lots of time off sick from my nursing job and was eventually dismissed. I applied for PIP but was turned down (scored 0), asked for reconsideration and sent a letter of detailed support from my mental health support worker and a family member. Still scored 0 because I had attended the appointment appropriately dressed and answered all the questions. Therefore I do not have any real problems with going out, engaging with others, communicating or self care. Yet I struggle daily with all these things and am frequently house bound and unable to do very much. Not sure if it is worth appealing though as if I turn up, will this go against me?

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  • Posted

    Saw this so many times volunteering at the Citizens Advice Beareau, my advice would be to go and see someone there as they have specialists who can help with these types of claims.

    Hope this helps

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    • Posted

      Thank you so much for replying. I will certainly give CAB a try to see if they can help.
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  • Posted

    Hi Sweepie

    Unfortunately, it is those with your condition who seem to have the biggest struggle when it comes to claiming PIP.

    The reason is the way PIP uses descriptors and the balance of probabilities. The descriptors with regard to depression revolve around ‘assistance, prompting and supervision’. To gain PIP on the grounds of mental health your condition would have to be ‘severe’ and medical evidence to that affect is needed.

    I don’t know what evidence you have but somewhere on your reports the word ‘severe’ (or a similar description) needs to be present. The threshold is extremely high and you would need to be taking strong medication and probably need a history of self-harm/suicides etc.

    Also the perception of the assessor is bound to be swung when he sees an appropriately dressed person answering all the questions without assistance.

    The DWP work on a balance of probabilities which means you were up against it right from the moment you walked into the assessment and started talking. Also there has to be a likelihood that you are affected by your condition more than 50% of the time, which again is going to be affected by turning up dressed properly and answering their questions.

    If you are going to appeal you need to get evidence which states your condition as ‘severe’. This needs to come preferably from a consultant or at least you’re GP. You then need to explain why you were dressed appropriately (carer assistance?) and why you were able to answer the questions without assistance (you were medicated, or superhuman effort?).

    I won’t lie it will be hard but as Dawn has suggested you could go to your local CAB or Welfare Rights for assistance.

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    • Posted

      hi Anthony.as you and others might gather I'm new to pip,but regarding post about depression and claiming pip,would it not be possible to ask for home assessment instead of traveling due to being housebound most of time,or is that not possible.ivan.

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    • Posted

      Ivan

      It seems PIP are more willing to do home visits than ESA. Generally the rule is, if you need a Doctor to visit you (rather than the other way around) then assessments can be done at home.

      Sometimes PIP arrange home visits without a request from the claimant. I think this is mainly for those who have adapted homes but I have known it happen to people who live in normal homes and have not required a home visit.

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    • Posted

      I was going to reply but you beat me to it giving the same advice as I would have done!!  

      I totally agree and with any claim for mental illness the poster should have good quality evidence (a) supporting the relevant descriptor and (b) describing the effect on their life as being in the extreme.

       

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    • Posted

      Of the two companies that carry out PIP assessments, CAPITA is more likley to offer a home visit in most cases. With ATOS they are extremely reticent to do the same - they want you to travel to a national centre to be tested. However it is possible with ATOS to get a home visit only if you can get your GP to certify to ATOS that the claimant's health would suffer dramatically if they left their home.

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    • Posted

      Do you not go to see your GP. your consultant etc? Who does your shopping etc?

      Those are the questions that you need to address.

      It would go in your favour if you never leave your home and that the medical professionals attend your home.

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    • Posted

      read your reply to depression.seems incrediblely hard on such folk.ive been there many moons ago and know it's incredibly hard to do smallest task,although i didn't claim for it.i think it v.good advice to get doc on side with letter etc.hope the guy read it.ivan.

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    • Posted

      Les I didn't know that CAPITA and ATOS had different policies but it would explain why there seems to be such a difference between PIP and ESA home visits.

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    • Posted

      Ivan it is incredibly hard to get PIP in most circumstances but the bar seems even higher with mental health. You have to remember the idea of PIP/DLA was to help the claimant with the extra cost of disability; it was never designed to be an extra income stream.

      In general the biggest extra cost is personal care, followed by the cost of aids and adaptations etc. PIP is funded by public money and those who are responsible for awarding it have to be sure it is going to those who need it most.

      This is where most of the conflict occurs. Claimants reasonably believe that once they have a diagnosis then that means they are disabled which should mean an entitlement to PIP.

      However, the PIP budget would soon run out of money if everyone who was diagnosed with depression was awarded standard rate daily living. Also with regard to physical disability or illness again there is a perception that PIP should be paid on diagnosis alone.

      However, there is always a huge degree of difference in severity with any condition and it is possible to live a next to normal life with a condition such as MS but in other cases a sufferer will require 24 hour care.

      That’s why the assessor’s have guidelines to follow and apply the balance of probabilities to any alleged needs put forward by the claimant.

      In mental health claims for PIP an assessor would be looking for extreme symptoms because the claimant would be relying on fitting the descriptors ‘assistance, prompting or supervision’. If the claimant is suffering from depression as their primary condition then in most cases they would be able bodied and there would be no physical reason why for example they couldn’t dress themselves.

      They would then have to prove on the balance of probabilities their condition was so bad that they need prompting or supervision from another person in order to dress, cook, wash and budget. Not only that they would also have to show this requirement was needed for  more than 50% of the time.

      The bar is so high that a claimant would probably need a diagnosis of severe psychological damage rather than a simple ‘depression’ diagnosis.

      That said I am no apologist for the system but I do believe that it is futile taking on the system without knowing the full facts about what a claimant is up against. I would still advise Sweetie to seek help from CAB but even with that help it won’t be easy.

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    • Posted

      Thank you so much for explaining this so clearly; I can now understand fully why my claim was turned down and why it is unlikely that I would win an appeal.

      I am going to apply for ill health retirement (as I worked for the NHS for nearly 20 years) instead and just pray that I have more success with this.

      Thank you again for your comments- very helpful.

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    • Posted

      Sweepie I'm only giving an overview on the brief details you have posted. I would still go to the CAB if I were you because I don't know your full details and there could be something I have missed.

      Yes it is hard to qualify for PIP but you should explore your options.

      As for ill health retirement believe it or not ATOS and CAPITA have a tendency to pop up with that procedure and you could find yourself having another assessment with them.

      However, the criteria and thresholds for ill health retirement are much less than for PIP, more along the lines of ESA. So your chances of achieving that are quite high as you have a history of workplace illness.

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    • Posted

      Yes, CAPITA does a lot more home visits than ATOS. They don't have to but they do.

      When ATOS was in charge of assessing ESA, trying to get a home visit was extremely difficult. They have now carried this into the PIP scenario - hence why each of the two do their own thing.

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