PIP not awarded... Any advice. I have up to the 22th May to appeal :/

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PIP not awarded 0 points! Advice please

Hello!

I had my PIP assessment a few weeks back I suppose I was having an OK day and my fault at the moment is putting a brave face on and always worrying what people think!!!! but after a 2 hour interview I was exhausted and deflated. I received a letter and report from PIP a few weeks ago and guess what I didn't get awarded.

A little bit about me. In August 2012 i just turned 32, collapsed with a full seizure. After a lot of tests and a 6 hour biopsy the hospital found a grade 2 large deep meningioma brain tumour. I am lucky it wasn't malignant but it has left me with cognitive problems, fatigue everyday, pain, focal epilepsy (seizures are now controlled but I do have auras but it could be the drugs) and I'm not the Gemma I used to be... I used to run 10K, go on nice holidays, see friends, family now I can't work because I am fatigued after walking 10 minutes and I feel pain everywhere especially my neck and spine (I have a lump that sticks out like a sore thumb like a hump) over the last few years I have been fighting to get well and I even tried dating again but didn't work out. I volunteered at a charity shop and came home crying because I couldn't concentrate, I felt fatigue, pain and I struggled on the till. I had tests done at the end of last year because I just knew something wasn't right I was then diagnosed with ME and wide spread pain. I've been through the wars and I don't want to dwell on my illnesses but I think after working from the age of 14 to 32 I deserve a little help. There is so much more I could put in this message but I think you can see I'm struggling in general. I've seen chiropractors, physiotherapists but I get migraines... I think it's all neurological my problems 😒

The ME clinic are going to write a letter to PIP to try and get them the change their decision but my occupational therapist isn't hopeful because I haven't been awarded any points. I can walk for 5 minutes and wash myself basically. Anyone got any advice/help to fight my case????? Very specific Examples to dispute????

I gave the PIP assessor and PIP so much back up. I'm now waiting to see a rheumatologist because the pain clinic are focusing pain to be just the mind and not the body ffs! I have appointments coming out of my ears.

Hope you are enjoying the weather. I'm lying down in the garden resting xx

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  • Posted

    Gemma i have no advce but as an M.E. sufferer myself i can emphasise and sympathise with you totaly. Im waiting for that brown ebevelope to come through the post any day to say ive got to apply for the PIP ( permanently imossible payment)!  Im dreading it and after reading your story, well im now convinced i havnt any hope of getting it at all.

    ​Someone did say if youve been diagnosed with M.E. then it automatically gets you through, yeh right like heck it does.

    ​Just how bad do you have to be and what do they need from us to convince them we were entitled when we got it as DLA years ago and still am now if circumstances havnt changed.

    ​Hope you get somewhere with them i really do. How can anyone with M.E. end up with zero points?!

    ​Sue

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  • Posted

    Hi Gemma

     

    Sorry about your recent experiences seems as though your luck is out at the moment.

     

    I can give you advice but you may not like some of it. I always work by the motto of tell you what you need to hear not just what you want to hear.

     

    Firstly PIP isn’t awarded on the basis of National Insurance payments or indeed because you suffer with a medical condition alone. PIP is awarded on the basis of how your medical condition affects you. The system is points based where each individual collects points if they match the descriptors. Collect enough points and benefit is paid.

     

    Descriptors cover Daily Care and Mobility. Daily Care involves assistance in cooking meals, dressing/washing, monitoring a health condition, budgeting and social interaction. Mobility has descriptors which include how far you can walk on level ground and planning a journey. The Descriptors can be found easily online (check them out)

     

    When you make a claim for PIP part of the process will be a face to face assessment. The assessor will be judging you from the first moment and will make a decision based on the balance of probabilities to whether you fit the Descriptors. Not only that but you have to pass the 50% rule. What that means is you have to fit the Descriptors for more than 187 days per year. You state that you put on a ‘brave face’ at your assessment. Unfortunately that assessment is the only opportunity you get to convince the assessor of your disability and if you appeared to them to be coping with your illness then that is the reasonable conclusion for them to come to.

     

    That doesn’t mean all is lost and you certainly can appeal, the first stage is to ask for a mandatory reconsideration within one calendar month of the date at the top of the decision letter. You have to tell the DWP decision maker why you think the decision is wrong. However, most MR’s are unsuccessful meaning you have to appeal to a Tribunal.

     

    What to do next? You seem to have a wealth of medical evidence which proves your condition. What you need to do now is prove how it affects you. You can try for an occupational therapist report. Trouble is if you get see one this year you will be very lucky!

    You can supply your own diary to explain any daily care you receive. You can get signed statements from anyone who provides care. List any aids or adaptation you have in the home you live in.

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  • Posted

    Hi gemma, i scored 0 points on mine too but got the decision over turned on mandatory reconsideration which is the next setp before you can appeal.

    ​You need to ring them and tell them you intend to ask for a mandatory reconsideration but but before they take any further action you want a copy of the assessors report sending to you, then you will put your request to them in writting. once you have done this you have started the process. when you get the report look at what the assessor has written about you then in your letter to pip you can counter what the assessor has said in your own way and then back it up with the extra evidence i.e the letter from the M.E clinic.

    ​I know from experience that the so called medical assessors lie through their teeth to make sure you don't get it. (mine did ) so getting the report puts you in a better position to get it overturned as you know what you are disagreeing with.

    ​scoring 0 points does not mean you won't get it over turned so keep fighting.

    good luck

    ​Gill.

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    • Posted

      PPS.

      Make sure you ALWAYS base your responses to the DWP on your worst of days. ALWAYS!!!!. 

      ​if you don't they will score you nothing.

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    • Posted

      Totally wrong advice!!!

      You have to tell them as it is. Nobody has the worst of days for 365 days a year. Many have in the past been prosecuted for overstating their difficulties.

      On the balance of probabilities you should show & prove that out of a year (365 days) 183 or more of them are bad days. So it doesn't matter if you are able to do most things with little or no pain for say 180 days in a year - they will assess you on the balance of 185 days.

      In my life I lead a fairly active lifestyle but that does not mean to say that I don't have awful days. Fortunately in my case my better days exceed the bad days so there was no point in claiming PIP. I keep a yearly diary giving up to 5 stars for every day on how well I felt or was able to function reasonably well. In the last year I had more than 183 days (total) which I marked as either 4 or 5.

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    • Posted

      Well i beg to differ les seen as that's the advice given on the disability rights own web site. I guess we're all wrong then.
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    • Posted

      Gill just wanted to back you up hear and thats true that the  so called medical assessors lie through their teeth to make sure you dont get it. They did with my son. Put down things he never said and didnt put things down he did say. Didnt want to know when he reported it all either, wasnt interested. Our grand daughter who has MS never got the PIP ether,  She has the worst kind, the agressive type too. 

      Sue 

      Sue 

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    • Posted

      Thanks, I have searched the DR website and cannot find such a reference advising claimants to make reference to the DWP based only on your worst days purporting to suggest that EVERY day is like that. Could you please help me out and point me towards such a reference. If in fact it does say that then I will not only apologise for getting it so wrong and at the same time take issue with that organisation and the DWP press office.
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    • Posted

      I have managed to find this passage from the DR website which explains how you should answer the questions in the PIP claim from:

      Describe the difficulties you face in as much detail as possible.

      •    Do you need help from another person to do the activity?

      •    If you do need help, what kind of help do you need? Does someone physically help you, reassure you, encourage you, remind or explain to you how to do something? Or do they need to supervise you?

      •    Do you use aids and/or appliances to help you in an activity? If you do, say what they are and how useful they are.

      •    Can you do some parts of the activity but not others?

      •    Are you unable to do the activity at all? Explain why.

      •    Can you do an activity but it takes you a long time?

      •    If your needs vary, describe in what way and how often? Explain about good and bad days or how your needs vary throughout the day.

      •    If you regularly have accidents – such as falls – or are at risk of having accidents, explain why and when they happen.

      •    Do you have any side effects from doing the activity? Do you experience pain, breathlessness, tiredness or stress and anxiety either during or after the activity?

      No where in that does it say that you should describe every day as your worst day.

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    • Posted

      my mistake les, it was the benefits and work website not the disability rights website... but regardless, you are advising based within the rules which the DWP itself doesn't follow.. if you played by the rules no one would ever be granted anything. so you have to play it the same way they do.. i'm sure you are very experienced in what the rules say. but until they start playing by their own rules then i'm afraid you have to just do what you can.. i know from persona experience that these so called medical assessors lie through their teeth and submit false report to the DWP. mine did. so it's not wrong advice at all... sorry to disagree with you.
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    • Posted

      If you have proof they've lied, then submit your evidence. They can't argue with fact. I presume you have evidence that they submitted a false report. I would contact my mp and make an appointment saying the medical assess ors have lied and are submitting false reports in order to stop claims. Never know you may make the nationals and tv. Lying and submitting false reports have to be investigated. Based on what you've said here, you have an open and shut case. Easy
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    • Posted

      Hi Susan

      I understand the frustration with the assessor but you need to be a little shrewder when challenging them.

      What you have to understand is that they make a decision based on the balance of probabilities. This involves matching your circumstances to the descriptors and satisfying the 50% rule in the main.

      It is a bit strong to state they ‘lie’ as their opinion is subjective rather than objective. If simple fact is if you don’t meet the thresholds then no benefit is paid.

      This is important when making an appeal. You will impress no-one by making accusations of ‘lying’ and it could harm your argument. It is better to adopt the forensic approach and point out where the ‘reasoning’ is wrong when determining the evidence to your specific circumstances.

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    • Posted

      Thanks. I know from bitter experience how the DWP and their 'medical' assessors 'play the game'. Unfortunately that does not mean that you can resort to their tactics and hope to get away with it. As I have said, no matter how or why they do what they do, it is the claimant that could well find themselves in court on a charge of benefit fraud if they willfully exaggerate their claim in order to obtain a pecuniary advatage.

      If the DWP and/or their agents want to play it their way, the time and place to have the matter challenged is at a Tribunal.

      Two wrongs do not make it right so to speak.

       

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    • Posted

      Absolutely!! it is a dangerous game to play if people think that if they can get away with it why not me?

      Prove to a court that they have lied and then complain and demand answers why it is that they think that the law only applies to the claimant.

      Unfortunately I have been down that road many times, and their stock answer is that the ESA/PIP assessors report is simply an opinion and not fact.

       

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    • Posted

      Hi Gill

      As stated the assessor makes a subjective decision based on your circumstances and the evidence provided including the face to face assessment. They don’t tell lies but they may come to a different conclusion. There are ways to challenge different opinions and it seems you were able to do that successfully.

      The idea of PIP was to target resources more to those who need it most. This means many people who qualify for DLA will lose out under PIP.

      It is wrong to state no one is awarded benefit unless they bend the rules. Many thousands of claimants receive PIP playing by the rules.

      I agree you should base your claim on bad days providing there is some perspective. Just because you had a bad week in March (for example) and required some personal care that doesn’t mean it covers the other 51 weeks in that year.

      The DWP rules are 50% of the time which seems reasonable. Therefore if you suffer your worst periods on average 3 and half days a week then it is reasonable to base your application on those bad days.

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    • Posted

      Totally agree with you. Hearsay is very different to actual fact. She must have seen the report in order to know it's false. Could be viewed as benefit fraud
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    • Posted

      Hi Anthony

      I was just agreeing with Gill hear, when our son gets someone to drive him to his  assessor interview and then he later reads they put he arrived on his on and could therefore drive the journey himselfe which he clearly couldnt and didn't, that is a lie. Im sorry but ive read loads of cases where they have lied on the paperwork, its not just my son.

      What is this 50% rule in main you mentioned, and what meets the thresholds, ill love to know.  What ever it is, they seemed to have made it almost impossible to achieve in most cases. 

      If they can deny our 21 years old grand daughter the PIP with MS some days she can barely drag her legs to walk, she is finding its affecting her bladder, she cant use her hands properly and lots of other symptoms, she told the truth 100% and was turned down. Just how bad do you have to be i wonder.  PIP was meant to replace the DLA. How can people that qualified for the DLA say 10 years ago suddenly be not be bad enough 10 years later, with many of us being older and feeling worse. The whole thing doesn't make sense. Its not transfering from DLA to PIP its about getting us off DLA and having nothing.

      Sorry Anthony im def not having a go at anyone personaly but im speaking from experience from seeing two of my family members suffering.

      Sue 

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    • Posted

      Gill

      be careful what you write on open forums. Anyone can see what you've written 'playing the same games, assessors submitting false claims' you can't go round saying stuff like that, unless of cause you want to be investigated for benefit fraud

       

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    • Posted

      My son submitted evidence but they wernt interested. How do prove that a friend had to drive you there and back home after the event? They see his friend walk in  with him and he told them someone else had to drive him there too. No way could my son drive himselfe yet this is what they implied,in their written report,  seems even being honest isnt good enough. Your damed if you do and damed if you dont. 
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    • Posted

      Hi Susan

      Believe me I don't want to defend ATOS assessors but it helps your chances to appeal successfully if you understand their role. To you it seems the assessor has lied but I'm sure if he was here to defend himself he would state it was his opinion based on what he saw and evidence provided. Look at it from his/hers perspective your son did arrive alone.

      OK he should have asked and clarified the situation but again it was his/hers opinion your son 'could have' travelled on his own even if he didn’t. When challenging the opinion it is perfectly correct for you to point out that he was accompanied to the assessment by someone else.

      That said it would only be relevant if having the inability to travel alone was part of his evidence and he was unable to travel alone more than 50% of the time. The 50% rule is a reference to ‘good’ and ‘bad’ days. You mention that ‘some days’ your Grand-daughter can barley drag her legs. The DWP rules are that she would have to have this disability for 50% of the time over the past year and the same would apply to her hands and bladder problems. The stark truth is if these problems are intermittent and only affect her less than 6 months per year then they are disregarded.

      The thresholds refer to the descriptors on daily care and mobility. Daily care covers cooking a meal, washing/dressing, toilet needs, monitoring a health condition, budgeting and social interaction. The assessor/DWP Decision Maker will decide on the balance of probabilities whether a claimant can perform these descriptors and if not what level of support they need. Each level scores points and if you collect enough points then benefit is awarded and paid. The same thing for mobility but there are only 2 descriptors, how far you can walk and planning a journey.

      The idea of PIP was to target the resources more towards those who need them most. The reality is it was an attempt to cut the welfare bill.

      It is my belief that some conditions which were accepted under DLA are now excluded by PIP. MS would be one of those unless there is overwhelming evidence the condition is severe. This is because MS suffers can take years to reach the ‘severe’ stage and therefore fail the 50% rule.

      I don’t agree with any of the rules I’m just giving the DWP rationale. Once you know the thinking you are in a better position to challenge their decisions. Believe me they won’t take any notice of arguments which rely on ‘well I qualified under DLA’ narrative.

      From the little you have posted your Granddaughter may well score points under cooking a meal (hands), dressing/washing (hands) & toilet needs (hands/bladder). Also mobility how far she can walk (dragging of feet).

      You need evidence of how the disability affects your granddaughter. You can try for an occupational therapist but it will be months before you get an appointment. A daily diary is a good idea detailing any personal care provided over the past year. You could do this retrospectively. Also anyone who has provided care can provide a signed statement confirming their involvement.

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    • Posted

      Thanks Anthony for clarifying a few facts hear, ill copy this and keep it for future reference 

      Sue 

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    • Posted

      As an example. I've just turned 68 and have been in receipt of Indefinite DLA (HIgh Mobility & Middle Care) since before 1995. 

      When it came my turn to move over to PIP at the back end of last year it was pretty obvious that despite failing health I would still not fit most of the PIP descriptors. I did a self assessment and managed 4 points.

      I also took on board the fact that with PIP you are more than likely to have re-assessments every few years leading quite possibly to Tribunal hearings. for the rest of my life.

      I simply didn't want to have to go through all of that year in year out and along with the maximum points that I could get being 4, I didn't do the transfer.

      Consequently my DLA was immediately stopped and so were other benefits that were supported by receiving DLA. I lost over £250 a week in total.

      Was I healthier than before. No, my health had deteriorated over the years. So I am no less disabled now than I was before. Yet I was fully aware that it was harder to get PIP than DLA. 

      Times move on, government policies move on so I was thankful that I had the help for the previous 19 years.

       

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    • Posted

      Les ive just read your comment to my hubby, he feels pretty much like you, doesnt look forward to a future of keep reapplying  for ever more. 

      Spose it depends on how much money one has left to survive on after losing the DLA . We will be living on our state pension and of course lose our free road tax on our car. Not to mention pension credit will end up going which then when on lower money qualifies us for paying council tax ?rolleyes

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    • Posted

      So they 'implied' that your son drove himself. They didn't actually write that he did
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