How to do a PIP reconsideration
You might find yourself having to do a PIP reconsideration request without professional help and this piece is intended to guide you.
- Call PIP and ask them to send a copy of the full assessment report – what you have in the decision letter is made up of excerpts from that 20+ page report and you should see the full report so that you can comment on it.
- If you have had an assessment on another benefit, such as ESA or universal credit, then ask them for a copy of that assessment report as it might contain findings that would be helpful to you as evidence. You might have a letter confirming that you have passed that test and even that you have been put in the support group/have ‘limited capability for work-related activity’ but it is the findings that supported that decision that could be far more helpful.
- If you have come unstuck on being moved from DLA to PIP, think how long ago you were assessed and if you suspect that the DLA assessment might have useful findings, then ask for a copy. It is more likely that any assessment for DLA will have been carried out by a doctor, which could help to counter what the PIP assessor has said. There was also a greater chance with DLA that the Department would have requested evidence from your GP, so you could ask for the evidence they used to make the DLA decision.
- Ask your GP surgery for a copy of your records going back to the start of the previous year. You are entitled to these records without charge.
Don’t just put such evidence to one side to be sent in without looking carefully through it. See later for advice on this.
Go through the test
I strongly recommend that you go through the test and decide where you should have scored points (which individual descriptor), making a note of why you should have scored them. Click https://www.legislation.gov.uk/ukdsi/2013/9780111532072/schedule/1 (please make nice link button) and scroll down to Part 2 where the full test is set out. Part 1 is where Parliament defined many of the important words and phrases used in the test. A look through Part 1 now would make sense so that when you are going through the test to see which descriptors you should have scored points for you can refer back and check that you are getting it right. For example, when looking at Preparing food, unless know that “cook” means heat food at or above waist height, you might think that you should have scored points because of the problems you have when using the oven.
Alright, you have been through the test and you know where you should have scored points and why. How are you going to prove this?
Sources of evidence
These can include medical and non-medical evidence, so think about:
- Who has seen for themselves how you are affected? Think about family members, friends, neighbours, colleagues, anyone who has relevant knowledge. Don’t worry that they only know about some of the things that you want to prove. Some clients suggest only one such person but other files have five or more. A statement would begin, “I Joe Bloggs of (address) make this statement in connection with the disability benefit claim made by my friend, Mary Smith.” I like to use separate paragraphs for each topic. In most cases, you will get more relevant statements by asking questions around the test activities you say are relevant and then make up a draft statement for them to add or make changes to. The statement should be signed and dated.
- GP records can be very helpful but it is important that you make sure that they are going to be supportive before you send them to the DWP. You are looking for two things are you go through them; for things that are supportive of what you are saying AND for entries and letters that undermine what you are trying to prove. I would not send an incomplete set of pages where they are numbered as I would suspect that you had left out something negative, if I was them. I have done appeals where it was hard to understand why the client had already sent in some of the medical evidence as it was against them, but they apparently hadn’t seen it. It is not unusual for there to be a mix of helpful and unhelpful entries so you might have a decision to make about whether to use the records or hold them back.
- Look at the assessment reports from other benefits and see if they contain findings relevant to what you are trying to prove. Sometimes I would use them if they did little more than show that the assessor found you to be a credible witness.
- You might have an occupational therapy report or an occupational health assessment. Your local authority might have decided that you should have a disabled parking badge, which could be relevant to your PIP claim.
I am not a big fan of letters written by GPs to support benefit claims. You are likely to be charged for one and they often do no more than list your diagnoses and medication. Even where they do include an opinion, my personal view is that they carry rather less weight than a letter or report written for medical purposes. Look at it from the position of the DWP Decision Maker or the tribunal; how valid is the GP’s opinion on what you can do in the kitchen, when bathing, dressing or even walking outside? Will what they do write about such tasks have come only from what you have told them? There will be exceptions and your doctor might have personal knowledge from their own observations but this ought to be in your surgery records.
Don’t worry if some of this evidence reaches you after you have had to put in the reconsideration request, to comply with the one-month time limit; you can always send it in separately with a very brief covering letter.
The PIP assessment report (PA4)
I urge you not to accuse the assessor of lying, regardless of how you really feel. Better to explain how they misunderstood what you said or point out factual errors. Even this is only worth doing where it is relevant to something you are challenging. Have a look at the end of the report to see when work on it was completed. I have found gaps between this date and the date of the assessment of up to 14 days. Such a gap can be put forward as a possible reason for the (relevant) errors or misunderstandings that you refer to. The first half of the report is supposed to be the history that you gave to the assessor while the second half is where they select a descriptor for each activity and explain their choice. Look at both as you may want to comment in your reconsideration request. The decision maker will generally want to accept what the assessor said and you will try to give them a reason not to. You may find that the assessor’s conclusion is based on a misunderstanding of what you said, or their reasoning in the second half of the report could be flawed. For example, you might want 3 points for needing assistance to get in or out of a bath (descriptor 4(e)) but what you said about this need has not been considered when they justify their choice. They are employed to express an opinion, whether you agree with it or not. They have a right to explain why they do not think that you need the help that you described but it must be wrong of them to ignore it.
The reconsideration request
I would rather write a letter than use the available form. Keep it relevant and as brief as you decently can. I don’t doubt that the Decision Maker is a busy person and I do not want to irritate them. You could begin with something like,
This reconsideration request is in respect of the decision dated …………. I consider that I should have had awards of (for example) the enhanced rate of both components of PIP, for the reasons set out below.
1(e) Needs supervision or assistance to either prepare or cook a simple meal
Then explain why you need someone there to provide that assistance, having looked up the meaning of “assistance”, of course. It is not good enough to state that someone else does it for you; the issue is why you could not do it, or what would/could happen if you did.
What is missing?
This piece is intended to help you make a workmanlike reconsideration request. What I cannot do is to pass on all the benefits of my 22 years of experience. I believe that I have a fair idea of the meaning given to words and phrases that are not in Part 1, given to us by Upper Tribunal judges, or those of the Court of Appeal and the Supreme Court. I may not be able to remember it all but I know where to find it. Where I am relying on part of one of these decisions, I can include the relevant passage in the reconsideration request and provide a copy of the full decision in case they want to read more.
I am probably better able to assess the strength of your claim for the points that you want but if you have scored very few or no points at all, do not be put off but be realistic about what can be achieved at this reconsideration stage. I don’t see the point in putting this sort of effort in with such a score. You may as well just ask them to look at the decision again, get the reconsideration done and focus your efforts on an appeal to an independent tribunal, where you are much more likely to succeed.
I wish you well