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Articles

PIP appeal in East London

18/01/2020 //  by DC-ADMIN

PIP appeal in East London

I have not come across a client with symptoms quite like Martin’s. Stress quickly makes his anxiety worse and it exacerbates his gastric problems so that our phone calls had been punctuated by retching and vomiting. He also suffered with heart disease and paranoid schizophrenia. The DWP had not done an awful job with his claim, awarding him the enhanced rate of mobility and leaving him just 1 point short of the enhanced rate of daily living. 

We always put in a written submission to the tribunal that sets out the client’s case and for Martin, it explained why we considered that he should score more points for four of the daily living activities. A tribunal has to the power to leave a decision unchanged but can also take away some or all the points awarded so we also covered mobility in the submission, explaining why Martin should have scored more than the 14 points that the DWP awarded. 

The judge recognised me from a previous visit to East London, which was nice, and the hearing began well with the judge telling us that the tribunal accepted what we set out in the written submission and that this was supported by the evidence we had sent in. They had been tempted to award 2 additional points and send Martin on his way with his four year award. However, they knew what could happen when such a short-term award comes up for renewal and they wanted to do more for him. 

The hearing continued and Martin was giving his evidence when he began to retch and we had to get to the toilet quickly. I am used to taking my bag with out with me when there is a short adjournment, because it could contain a recording device but the judge wanted all our papers out of the room as well. With hindsight, I should have understood why he gave that instruction. Once out of the toilet, the clerk passed a message to the tribunal to say that we were ready to resume, so we waited. We waited so long that, with no sign of the clerk, I reluctantly knocked and put my head around the door of the tribunal room. The judge was typing at the clerk’s table; he said that they had allowed Martin’s appeal, with him scoring “11 million points”, surely an unusual remark from a tribunal judge.

I was asked to go in alone, just to pick up the copies of the decision. The judge said that he doubted he had ever awarded anyone 27 points for daily living before. The award for mobility was also increased, from 14 to 22 points. The decision notice was the most strongly worded I can remember seeing, in support of their decision to give an indefinite award to this young man. The judge went out of his way to be helpful, explaining in the decision notice that the nurse who did his assessment had gravely underestimated the extent of Martin’s mental disablement. 

Martin was hugely relieved at the outcome. 

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PIP Case Studies

PIP appeal in East London

By DC-ADMIN | 18/01/2020
PIP Case Studies

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Category: Articles

PIP appeal in Inverness

15/01/2020 //  by DC-ADMIN

PIP Appeal in Inverness

My plans to fly to Inverness for my first hearing there were wrecked when an afternoon tribunal hearing in Cardiff overran and made it impossible to get to Bristol Airport in time. There was nothing else for it but to drive as I was not going to let the client down. Everything worked out and that appeal was allowed. It was less tiring to fly to Inverness for this appeal and we had a modern court building rather than the quaint room in a church on my last visit. 

This client, K, had been awarded just 2 points for the daily living component and nil for mobility. My advice from the start was that his appeal was not an easy one but that I considered him to have a better than even chance of success. His hearing was not a routine on, in that the tribunal required K’s partner to be outside the room when the client gave his evidence. I have only seen this a handful of times in 23 years but I consider it to be helpful as it allows them to give more weight to the witness’s evidence when they can see that it was not influenced by what they heard during the hearing. I was very pleased with the evidence they both gave. 

K’s mobility claim was based on his anxiety and for us to succeed, the tribunal would have to accept that he needed to be accompanied on any journey ‘to avoid overwhelming psychological distress’. My view was that the meaning for that wording that the DWP included in the appeal papers was a gross distortion so took my huge Oxford English Dictionary to Scotland to support the meaning that we said the phrase should have. 

I did not expect a call from the client after I landed back in Bristol but K had called the tribunal, just on the off chance, and had been told that he appeal had been allowed, with an award of the enhanced rate of the mobility component. A good outcome as I consider this to generally be more difficult to get, especially when the claim is based purely on mental health. 

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ESA and PIP appeals in Birmingham

18/12/2019 //  by DC-ADMIN

ESA and PIP appeals in Birmingham

The Tribunal Service helped by listing Jon’s two appeals on the same day as it avoided travelling to sunny Birmingham a second time. Years ago, if a client had appeals for both ESA and PIP, they were listed before the same tribunal but a policy decision stopped that. It was awkward doing it that way since the panel for a PIP appeal includes a ‘disability qualified panel member’ whereas for ESA, it is just the tribunal judge and a medical member. 

ESA had found Jon capable of work with a score of zero points. His appeal against that decision was heard in the morning and went very well with the tribunal awarding 18 points, more than the required 15 points. They also agreed with us that Jon should have qualified for the support group, so that he got the higher rate of benefit and was not required to carry out ‘work-related activity’. 

Jon, his father and I ate sandwiches in the waiting area because the PIP appeal was listed for just after lunch. It had been explained to us that the PIP panel would be given a copy of the morning’s ESA appeal decision. Jon went into the PIP appeal with 2 points for the daily living component and 4 for mobility, so no award. However, our appeal was refused, the tribunal confirmed the DWP’s decision. We were surprised and disappointed, and I could not tell why they refused us; certainly, there was nothing wrong with the evidence they heard that day. I remained convinced about Jon’s entitlement to PIP, that he should have had the enhanced rate of both components. We don’t just walk away from a client in a situation like this, so it was agreed that I would ask the judge for a statement of their reasons for the decision, the idea being that if we could find an ‘error of law’ in that statement, then we would try to get it set aside by the Upper Tribunal. 

I considered that there were errors of law in the statement of reasons that arrived and I put together an application for permission to appeal to the UT. That application was dealt with by a judge sitting alone and we must have done a decent job because instead of giving us permission to appeal, that judge set aside the first tribunal’s decision and directed that Jon’s PIP appeal be re-heard by a different panel. This avoided what would have been a very time-consuming process. 

Jon still had a long wait for that re-hearing in Birmingham but it was worth it as the new panel agreed with our assessment of his entitlement so that he got the awards of the enhanced rate of both the daily living and mobility components of PIP, backdated of course to the original date of claim.

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From DLA to PIP

15/12/2019 //  by DC-ADMIN

From DLA to PIP

We helped John from Coventry with his move from Disability Living Allowance (DLA) to PIP. As usual, the work was done by phone after he sent the signed form to us. His DLA award was lower rate mobility component and lowest rate care component. We always provide clients with a copy of the agreed form wording and detailed written advice on their entitlement. This typically sets out what we expect them to get from the assessor/decision maker, and what they are actually entitled to, in other words, what we would expect to achieve with an appeal to an independent tribunal. There should not be such a difference since the same test and law is being applied by both, but we do not find this to be the reality. A client needs to know what is likely to happen in practice, as well as what could be achieved if they went on to fight for their full entitlement. 

On John’s PIP conversion claim, he was awarded the standard rate of both the daily living and mobility components. Since there is no equivalent of lowest rate DLA care, this represented an improved award and more money so John was pleased and relieved. A typical PIP award lasts for three years and we were also happy that his award was for 5 years.

He scored 11 points for daily living, just one short of the 12 needed for the enhanced rate. Our advice was that he was unlikely to improve on 11 points at the mandatory reconsideration stage and would need to appeal to a tribunal to achieve his full entitlement. John had a difficult decision to make; our job is to give a client clear objective advice on which to base such a decision. He chose to stick with his improved five-year award.

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Deciding Appeals in the Absence of Claimants

18/11/2019 //  by DC-ADMIN

Deciding Appeals in the Absence of Caimants

Can it ever be a good idea to have your appeal heard by a tribunal without attending? We don’t think so. We have represented clients at face-to-face hearings where the client has been unable or unwilling to attend, but family members came in place of the clients. I certainly remember attending with a client’s parents, with a sister and with a daughter and those appeals were allowed. We have also attended at least two hearings where no one could come; one was allowed but the tribunal adjourned the other as they were unhappy with having just the representative. That appeal lapsed because the DWP changed the decision and gave us the enhanced rate of both components. 

A number of clients have come to us after opting to have their appeals heard without them but where the tribunals have thought that there was merit in the case and they have been reluctant to hear the case, because that would have meant dismissing the appeal. Instead, those tribunals adjourned and issued directions which encouraged the appellant to attend when the appeal was listed for an oral hearing. Think very seriously before you throw this opportunity away as the tribunal is doing its best to signal that you have a chance of winning but they need more information from you. You cannot use this as a way of gauging the strength of your appeal because tribunals are discouraged from adjourning on costs grounds so that most would not think twice about hearing and refusing your appeal, regardless of its potential.

Challenging a tribunal’s decision

If you are unhappy with a tribunal’s decision, either because your appeal was refused or it was allowed but only in part, the starting point is to request a statement of the tribunal’s reasons for their decision, and a copy of the ‘record of proceedings’. You have a calendar month in which to ask for these and that month begins on the day you were given or sent the written decision. These days, the record of proceedings is very likely to be the official recording of the hearing, rather than any note of the evidence that was made by the judge during the hearing. This is unfortunate as the hand written record would sometimes reveal an important misunderstanding on the part of the judge. 

It is necessary to find one or more ‘errors of law’ in the statement of reasons and to ask in writing for ‘permission to appeal’ to the Upper Tribunal. You will not be given permission to appeal by arguing that the tribunal made the wrong decision, that they should have awarded more points or that a new piece of evidence would have made a difference if the tribunal had seen it. The focus now changes from these matters of fact to matters of law. It is outside the scope of this article to equip you to identify errors of law in the statement of reasons, but here is a list of the most common ones:

  • The statement of reasons shows that the tribunal applied the wrong law, that it overlooked relevant case law or that it misunderstood the legislation.
  • The tribunal made incorrect factual findings; it might have failed to make a necessary finding or took irrelevant facts into account.
  • It gave inadequate reasons for its decision.
  • The tribunal’s decision is not supported by the evidence, which could include ignoring or overlooking evidence, misinterpreting evidence or taking irrelevant evidence into account.
  • The tribunal’s decision is perverse, meaning that it acted irrationally and in a manner that no reasonable tribunal could have acted, given the evidence before it and the findings of fact made. This option may look attractive but the bar is a high one and it will rarely apply.
  • There has been a breach of the rules of natural justice, referring to a failure to follow procedure. This can be quite wide ranging but examples could include not allowing a party to the appeal to speak or evidence of bias.

I have seen an unrepresented appellant granted permission to appeal but I am in no doubt that an experienced and knowledgeable representative would do a better job. Worryingly, we have come across too many representatives who recommended that it was better not to try to challenge a tribunal’s decision, simply because they were unsure of how to go about it. We find that there is usually a material error of law to be found in a statement of reasons. 

Your application for permission to appeal to the Upper Tribunal will be decided by a judge sitting alone and without a hearing. We find that at least half of our applications are refused by these judges. Do not be put off by this; you will be provided with an Upper Tribunal form UT1, on which to apply directly to the Upper Tribunal for permission to appeal and we find that the more knowledgeable judges there are very likely to agree with the exact same grounds that failed to impress the local judge. 

 

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Now that’s what I call a PIP reconsideration request..

15/11/2019 //  by DC-ADMIN

Now that's what I call a PIP reconsideration request..

We helped Cathy with her claim for PIP and we always confirm our advice on entitlement in writing. That advice to a client is usually that there are two outcomes; what she is really entitled to, being what we would expect a tribunal to award on appeal, as opposed to the points we expect the assessor and decision maker to award. There should be no such difference because everyone is applying the same law, but experience tells us that the difference does exist. We explain all this to a client in plain English, not trying to impress with jargon. 

Cathy received from us a score sheet that highlighted her relevant descriptors, the detailed letter of advice and a copy of the agreed wording on her claim form. They are all used when we prepare a client for their assessment, once the date for this is known, and clients tell us that this call of 20 to 60 minutes has been invaluable to them. 

Our advice to Cathy was that she should not score fewer than 10 points for daily living and 20 for mobility. The decision to award 8 points for daily living and 10 for mobility was surprising and disappointing. We don’t know what was said by the client during the assessment but we do know that the decision was wrong. We gave advice on Cathy’s options and she trusted our judgment and instructed us to request a mandatory reconsideration. We went carefully through the assessment report with her when this arrived as it is important to see where the claim had gone wrong. In the meantime, we asked her to request a copy of her GP notes from her surgery, which we went through page by page. We took statements from people who had seen for themselves how Cathy was affected by her medical conditions and set out her case in a letter to the DWP, explaining where points should be scored and why, supporting this with Upper Tribunal cases. We always ask a client to comment on a tribunal submission or a reconsideration request as it is important that we have correctly understood how she is affected. 

According to the Government’s statistics, not many reconsiderations result in any additional points being awarded, never mind getting to the right award, so it was very pleasing when they increased her score to 21 points for daily living and 22 for mobility. We had also put forward reasons why the award should have been for more than the usual three years, but were unsuccessful here. Cathy was happy and the effort put into her case had been well worthwhile.

 

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Moving from DLA to PIP

18/10/2019 //  by DC-ADMIN

Moving from DLA to PIP

Diana and her husband live in Suffolk and came to us for help with moving from DLA to PIP. Her award at DLA was higher rate mobility and the highest rate of the care component and this was an indefinite award where she was last assessed by the Department in 2002. She suffers with COPD, emphysema, bronchitis, eczema, a bilateral hearing loss and has two fractures to her spine. Diana signed her PIP claim form, posted it to us and we completed it together in April of this year. Our view was that she should score a minimum of four points for Preparing food and that the reality is that she cannot prepare and cook simple meal, so should score 8 points for this part of the test. Even when sitting, Diana has to support herself on her arms in order to take pressure off her spine and moving around her home, she has to rely on furniture, door frames and worktop etc. Because she used to be affected by cooking fumes and had to take more medication as a result, she stays out of the kitchen when cooking is going on and for this combination of reasons, we said that the descriptor that reads, Cannot prepare and cook food, was a good fit for her.

Because Diana struggles to get some of the medication out of the blister packs and she cannot get the lid off another, we were confident of her scoring 1 point for her need of assistance to manage medication. She regularly needs help to turn the oxygen cylinder on or off. She was also forgetting to turn the supply off because she finds struggling to breathe to be very distracting. Our advice was that this assistance with oxygen therapy should lift her score this part of the test from 1 to 2 points. With Washing & bathing, the strongest claim was for 3 points because of the need for assistance to get in or out of a bath. Diana had a grant to cover conversion to a wet room, so there is no bath. Despite this, the question of whether Diana could get into and out of an unadapted bath without assistance is still relevant. Case law from the Upper Tribunal in 2016 pointed out that an inability to get in or out of a bath, or a shower, will trigger the 3 points. Washing and bathing is a physical task and not surprisingly, Diana's breathing is affected. The whole process takes her nearly an hour and she then needs to use oxygen and lie down to recover. Arguably, 8 points could have been scored under the heading of Washing & bathing because she cannot achieve the task within a reasonable time period, applying regulation 4(2A).

Rails were provided as part of her grant work to get her back to her feet after using the toilet and her claim to 2 points for the need to use an aid or appliance was strong. When it came to Dressing & undressing, Diana is one of the people who has to sit to do this. Case law tells us that whatever she sits on cannot count as an aid or appliance because many people who do not have a disability also need to sit down for this purpose. However, she has to use a cabinet to get back to her feet and the cabinet counts as an aid because people who do not have a disability are able to get to their feet without using anything.

Diana wears two hearing aids, prescribed by the hospital and we had no doubt that 2 points would be awarded for Communicating verbally.

Diana's claim under the heading of Planning & following journeys was a little out of the ordinary. The issue for her is that she never knows when her breathing will worsen. It has been triggered by wind, cold, vehicle fumes and grass being cut nearby, and so she is understandably anxious. The person with her does not really have a role but they provide reassurance simply by being there. Again, there is case law from the Upper Tribunal saying that passive reassurance is enough to trigger points for being unable to follow the route of even a familiar journey without another person. Another Upper Tribunal decision states that the anxiety has to be strong if points are to be scored on this part of the test; the threshold is a high one. That case instructed us to read the words “to avoid overwhelming psychological distress” into the descriptors, even though those words do not appear there.

Based on information that Diana provided, we ticked the less than 20 metres box on the form and described how her walking is affected by shortness of breath, as well as back pain. She has a hoist to get her scooter out of the car and without that, bending would be involved, which is impossible for her. When going out without the scooter, she is pushed in her wheelchair and the very little walking that she does without these aids is carried out with physical support from her husband, with frequent halts and the walking is very slow. Overall, we were confident of a score of 12 points for Moving around.

Diana received a date for an assessment about six weeks after the form was posted, ‘signed for’, and she was able to use the copy claim form sent to her, together with a copy of the score sheet that we put together at the same time. Clients are also supplied with information sheet on how best to handle the assessment but there is always the offer of a telephone discussion before the assessment because this gives an opportunity for tailored advice. That discussion took place three days before the assessment, so as to be fresh in their minds. Files stay open until we find out what the decision on a claim was and we were delighted to learn that Diana had been awarded the enhanced rate of both components of PIP, so that she kept the same value of payments. It was particularly pleasing that her award has no end date. We explained that with such long awards, she can expect a ‘light touch review’ after say, 10 years.

A good outcome, with the client receiving exactly the award we wanted.

 

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PIP appeal in Leicester

15/10/2019 //  by DC-ADMIN

PIP Appeal in Leicester

The DWP accepted that Sally could make no use of her left arm, that she had no movement in the arm or ability to grip. In spite of this, they awarded her just 6 points for the daily living component and there were no points for the activity of Washing and bathing.

It seemed pretty clear to us that a person who can make no use of their left arm cannot wash their right arm without help (you try it). The descriptor 4(f) reads, “Needs assistance to be able to wash their body between the shoulders and waist”.

Sally’s right arm came within that area, which is why we wanted 4 points for Washing and bathing. You might initially think of her scoring 2 points for the need to use an aid; or, 3 points for needing help to get in or out of a standard bath, but regulation 7 says that where two or more descriptors apply to a claimant, then the higher or highest descriptor should be scored. Sally had sensibly thought about getting a report from an occupational therapist, and to avoid the wait for the local authority to do this, she approached a private OT service at a cost of about £250. The report made no mention of PIP as the reason for their assessment, which added to its value, in my view. We regularly see references to PIP claims and appeals in GP records and we can see why these take away from the weight given to the doctor’s evidence. There is probably a concern that the doctor might give in to pressure from their patient.

The private occupational therapist tested Sally’s left arm and the report confirmed that there was no sensation in the lower arm. We explained in our written submission to the tribunal that scars on Sally’s left arm had been caused by splashes, burns and scalds which she had been unaware of at the time, and the OT report helpfully referred to those scars.

The tribunal judge explained at the start of the hearing that our submission and supporting evidence had persuaded them that Sally should have qualified for the standard rate of the daily living component but that since we wanted an award of the enhanced rate, the hearing would go ahead and they would hear oral evidence from her. Sally did very well and her evidence was consistent with what was in our submission; clients are asked to comment on their submission before it goes off to the tribunal but the stress of a hearing can have strange effects. Her evidence, together with the medical evidence already sent in and the occupational therapy report persuaded the tribunal that Sally reasonably required supervision to be able to prepare and cook a simple meal, increasing her score for Preparing food from the 2 points awarded by the DWP to 4 points. It is worth noting that the legislation defines
“supervision” as meaning “the continuous presence of another person for the purpose of ensuring the claimant’s safety”. These additional 2 points, and the 4 points for Washing & bathing, took Sally to the 12 points she needed for the enhanced rate.

Sally’s arrears from her appeal amounted to around £5,300 but it would have been better if more common sense had been applied and the 12 points had been recommended by the assessor, or awarded by the first decision maker or the decision maker who carried out the reconsideration, or even the Officer who put together the appeal papers.

At least justice was done in the end.

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15 Points for Mobilising and Support Group Placement

18/09/2019 //  by DC-ADMIN

15 points for mobilising and support group placement

Enhanced PIP mobility and standard rate daily living component but only 6 points for ESA Mobilising

Jeff was awarded just 6 points for ESA so he was found fit for work. PIP had awarded him the standard rate of both components and his mobility points had been scored for Moving around, so for his physical limitation. We do appreciate that there are important differences between the ESA and PIP tests for mobility. One of these is that even it was accepted that a claimant could not walk more than 50 metres without having to stop, a finding that they could mobilise more than 50 metres using a suitable walking aid, such as a manual wheelchair, then the 15 points would not be awarded.

It would have been reasonable though if ESA had taken account of the Department’s own findings that supported his awards of standard rate PIP daily living component and enhanced rate mobility component. It is important to distinguish the findings from the award; using the award as evidence can be helpful but the findings that supported the award can be much more powerful. This is why we recommend that you ask whichever Department for a copy of the full assessment report, whether or not it was based on a face-to-face meeting.

The Department was represented at Jeff’s ESA appeal hearing but that Presenting Officer said that she was bound by what was in the Department’s supplemental submission. They were not moved by any of the additional evidence that had been sent in so no additional ESA points were conceded at the start of the hearing. The way it was phrased suggested to me, and perhaps to the tribunal, that the Presenting Officer had her own view.

The Presenting Officer was not available when the tribunal clerk invited us in to the room to receive the decision and Jeff opted to stay where he was so we went in on my own. The judge said that it had been an easy decision for them to award 15 points for ‘limited capability for work’, which also placed Jeff in the support group. The tribunal also recommended to the DWP that Jeff should not be reassessed for 24 months from the hearing date. Jeff and his wife were delighted, relieved and a little tearful.

It seemed to us to have been an appeal that did not need to happen.

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Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.
Non-necessary
Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. It is mandatory to procure user consent prior to running these cookies on your website.
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