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PIP & ESA appeal over 29 months

06/08/2020 //  by DC-ADMIN

PIP & ESA appeal over 29 months

I had a call from Jonathan’s dad in August 2017 and we agreed a reduced fee for two appeals, ESA and PIP. ESA had found him fit for work, scoring zero points. PIP refused benefit too with him scoring 2 for daily living and 4 for mobility; not very promising on day one. Essentially, Jonathan suffered from depression, anxiety and OCD.

I asked for the two appeals to be heard by the same tribunal, to save Jonathan from having to endure two hearings with different panels and almost certainly on different days but this was refused; the judge pointed out that the ESA appeal would be heard by a panel of two whereas the PIP panel would include a Disability Qualified Panel Member. I had seen it done before, where the DQPM sat out of the second appeal but the guidance on such arrangements had changed so they were right to say no. 

Jonathan’s dad is a very determined man and he had arranged for a psychotherapist, Jane, to help his son over quite an extended period. He brought Jane in as an ‘expert witness’ at his own expense and I took a statement from her, to be sent in with the other evidence and tribunal submissions. She was also to attend the hearings to give oral evidence and answer questions. 

Two hearings on one day

Some farsighted individual did us a kindness by listing the two hearings in Birmingham for the same day in August 2018, morning and afternoon and the ESA came up first. This went well with Jonathan’s appeal being allowed with the necessary 15 points coming from 6 points for each of three Activities, Coping with change, Getting about and Coping with social engagement. We also argued that he should be placed in the support group so that he would not need to carry out ‘work-related activity’ to receive his benefit. There is a separate test for this, set out in Schedule 3, but our case was not that any of the 17 ways into the support group applied to Jonathan. Instead, we argued that the exceptional circumstances provision in regulation 35(2) did apply. The tribunal accepted that there would be a substantial risk to Jonathan’s mental health if he had to carry out work-related activity. They also recommended to the DWP that he should not be re-assessed within 24 months of the hearing date, which I believe to be the maximum. Job done.

PIP & ESA appeal over 29 months - Disability Claims

Round Two

We munched sandwiches to keep our strength up in the particularly long waiting area that has a cluster of hearing rooms at each end. The PIP appeal was to be heard at the other end after lunch and we saw what we suspected was the ESA decision being taken from the first room to the second – we had been told that the PIP panel would be made aware of the morning’s decision.  Did the second panel want to rain on our parade? Were we too relaxed at the PIP hearing? Who can say but they were unmoved by our evidence and we made no progress at all in terms of points; Jonathan still had 2 points for Engaging with other people and 4 for needing to be encouraged to leave the house, as before. Disappointed did not quite cover it.

Down but not out

None of us were persuaded that we were barking up the wrong tree so we requested a statement of the tribunal’s reasons for their decision, and a copy of the record of proceedings, the judge’s note of the evidence taken at the hearing, with a view to challenging the tribunal’s decision, which can only be done on a point of law. 

I applied for permission to appeal to the Upper Tribunal on six grounds and this was considered by a judge sitting alone in January 2019. He considered that our first ground clearly showed that the PIP tribunal had applied the law incorrectly and there was no need to send the case to the Upper Tribunal. Instead, this judge set aside the decision and directed that Jonathan’s appeal be re-heard by a different panel. He said that the other five grounds may be arguable but that he did not need to decide those points as the appeal would be re-heard anyway.

Round three

After a second postponement request on our part, this time due to a witness being restricted by a broken leg, we got our second go at the PIP appeal in January 2020. We were all present and correct and this panel seemed to understand where we were coming from. Everyone on our ‘team’ stepped up and gave their evidence very well. This resulted in Jonathan scoring 12 points for daily living and 12 for mobility for a period of five years. He scored for Preparing food, Managing treatment, Washing & bathing and 4 points for Engaging with other people. The tribunal accepted that he needed to be accompanied on even a familiar journey and his arrears dated back to February 2017.

Three hearings over 29 months but we got there. A great team effort and a nice family too.

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PIP Articles

PIP payments backdated

18/11/2020
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PIP Articles

Challenging a PIP tribunal decision

31/10/2020
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PIP Articles

How to do a PIP reconsideration

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Enhanced PIP Benefits

31/10/2020
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PIP Claim – Change of Circumstances

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ESA Case Studies

PIP & ESA appeal over 29 months

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PIP for Depression and Anxiety

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PIP Appeal in Sutton

28/04/2020
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Category: ESA Case Studies, PIP Case Studies

PIP Appeal in Sutton

28/04/2020 //  by DC-ADMIN

PIP Appeal in Sutton

Moving from DLA

It was the client’s dad who called me from Liverpool in July 2018 about M whose DLA was going to end because she was having to claim PIP instead. She had higher rate DLA mobility and middle rate care and M and I did the claim form together a month later. I sent her the usual detailed advice on where she should score points and what award she should expect. The letter explains that there is often a difference between what I would expect from the assessor and decision maker, as opposed to what I would expect from a tribunal on appeal. I also recommended a move from income support to employment and support allowance (ESA) as this would give her more money. All being well, her ESA award would also include a severe disability premium, boosting her income still further.

What we expected

M struggles with a range of problems including mental health issues, a spinal problem, knee pain despite operations on both, and fibromyalgia. I could not see M scoring less than 11 points for the daily living component of PIP and considered that she would score much higher than this on appeal. I described her claim for mobility as difficult to assess, saying that the decision maker was unlikely to understand/apply the law correctly, but I could not see her scoring less than 10 here too, so getting standard rate.

What we got

Her award was just 8 for daily living and a whopping 4 for mobility. The 8 points were for the ‘usual suspects’ of preparing food, washing, toilet needs and dressing, while they considered her capable of walking between 50 and 200 metres. Slightly bonkers and we set about fixing this with a request for a mandatory reconsideration. I took witness statements from her ex, three friends, a neighbour and her carer. We did make some progress at this MR stage as we got 10 points for mobility, so standard rate, but no movement at all on the daily living side.

Onwards

The new award of 8 and 10 was not right, so we lodged an appeal in March 2019. ESA considered her able to walk up to 100 metres, but accepted that there would be “severe functional impairment in reliably and repeatedly mobilising”, which was helpful, but we gathered more medical evidence.

HMCTS Sutton

We wanted a shed load of additional points for daily living. The plan was to move from 10 to 12 for the physical side of walking but we also had things to say under Planning & following journeys. I sent in a detailed submission for the tribunal. Looking back, this was one of my ‘old style’ submission, much too long by today’s standards. I took advice from two District Judges at a Tribunal Users Group meeting and the submissions I write these days are leaner and more effective. Only rarely to I get to see how other people write submissions, but I saw one put together by a firm of solicitors that gave me the firm impression that it was intended to impress the client rather than be something for the tribunal to use as a plan for the hearing and a working tool for the representative’s use during the hearing; this solicitor may not have been in the habit of representing in person, which might explain their chosen format. 

The hearing was listed in Sutton in August 2019 and the hours of preparation had been done so I was good to go. I felt that we had a good chance of success, of getting M from standard rate of both to enhanced rate of both.

The call

With a hearing start time of 2.55 there was plenty of time to drive there, no need to stay overnight local to the venue. I was on the M25 when I got the call to say that the tribunal had felt able to give us the award we wanted, based on the submission and the evidence we had put in, and that there would no need for them to hear from M in person, or from me. Job done.

The meeting

Contact with most appeal clients is by phone and email so I do not get to meet them until the day of the hearing. I wasn’t going to get to meet M at all, yet we were quite close as the traffic had been kind that day. We decided to meet up, so I got to meet here and her fluffy cats. 

The moral

The hours of preparation before the hearing day didn’t help, except that you really don’t know how any hearing is going to go, tribunal panels are unpredictable and you do not want to go in feeling anything less than fully prepared. Yes, a good panel will make it easy, asking all the right questions and having a proper understanding of the facts and the law. Trust me though that there are panel members, including judges, that with all due respect to them and their position, display wrong thinking. I must be approaching 2000 tribunal appeals in my 22 years, but I still get caught out on occasion by panel members who ask questions that they would not ask if they understood the law on that point. 

PIP Appeal in Sutton

I have been comforted by a knowing nod from a judge when I began to open my mouth to challenge something, but sometimes it is the judge themselves who comes out with something that has me reaching for my law book so that I can try to put them right when it is my turn. A representative has to be there, in my view, because most clients are not equipped to deal with the panels who are clearly looking for a reason to say no, or those whose knowledge of the law on part of the test can make all the difference to an outcome. Anyway, this one went well and with an arrears period of 43 weeks, M was set to receive about £2,800.

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Categories

  • ESA Case Studies
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Archives

  • November 2020
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PIP Articles

PIP payments backdated

18/11/2020
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PIP Articles

Challenging a PIP tribunal decision

31/10/2020
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PIP Articles

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31/10/2020
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Category: PIP Case Studies

This PIP appeal in North London needed Pebbles help

14/02/2020 //  by DC-ADMIN

This PIP appeal in North London needed Pebbles to help

North London living L came to me in September 2019 with a PIP appeal assistance request regarding a PIP decision made 15 months before.

She had scored 8 points for daily living and 4 for mobility, so just enough for an award of standard rate of the daily living component. Her problems are a mix of physical and mental health and after we talked about how these affected her in the context of the PIP criteria, my advice was that she should have had awards of the enhanced rate of both components. The PIP appeal was lodged online three days later and we started thinking about where evidence would come from to support our view. The Department’s appeal papers contained GP notes and we added a witness statement from L’s sister and mental health notes. We went through the report put together by the physiotherapist employed by ATOS Healthcare and one thing that struck us was how little had been written in certain areas. The physiotherapist seemed to be out of her depth with problems that one service provider described as too complex for them to help with. In one section of the report, L was described as being withdrawn and a few lines further on, not being withdrawn. You don't have to be with L very long to be surprised at the physiotherapist assessing her as not being agitated or tense; at least she was described as walking at a very slow pace and appearing to be in discomfort, so it could have been worse.

Traumatic life events can knock anyone off course but L has been three such events and to her credit, shows signs of getting back on track. I knew that it was going to be more than difficult for her on the day the hearing and I was concerned at not being able to reach her on the phone the day before. When we spoke on the day, it was all I could do to get L to agree to come to the waiting room at the tribunal venue; she did not expect to be able to come into the room itself. The hearing was in North London, over three hours from our base, but with the start time of 3.00, it could be done in a day. L messaged on the day of the hearing to say that she really couldn't come, not being able to cope with the idea of seeing people who knew what she had experienced. It helped that my partner was with me and that she would be able to wait with her while the hearing took place. Being told that we had our chihuahua, Pebbles, with us and would bring her into the tribunal venue clinched it. L said that would be calming. We have always thought that Pebbles would make a great therapy dog. One or two clients have met her back at the office that this was the first time that she had been into a tribunal venue. From the reaction of the security guard and tribunal clerk, they don't get too many dogs in there.

This PIP appeal in North London needed Pebbles to help - Glenn Brooks, Disability Claims

My hope was that once she got to know Pebbles, L would feel able to come into the tribunal room with Pebbles on her lap. It would be up to the judge but since part of the overriding principle enshrined in the law is about enabling claimants to take part in the proceedings, I was hopeful that a judge would make an exception. Pebbles behaved impeccably and proved to be a great comfort but L did not feel able to go further than the waiting room. Her sister, the author of a witness statement, was happy to come in. We went into the tribunal room and got settled. The judge did the usual introductions of the panel members and explained that having been through what she described as our detailed and helpful submission, together with the evidence in the appeal papers, they had been able to decide the appeal before we went in. The three panel members had the appeal papers two weeks or more before the hearing, but it is not until the day that they meet and can consider them together. The written decision had already been typed, so full marks to the tribunal clerk who evidently knew this but had given nothing away cup. They had taken L from 8 to 12 points and had added 10 points for mobility as well, with a four year award. On a personal note, I was pleased that they had accepted our written submission about Engaging with other people and had added the 4 points here, for the need for ‘social support’, applying a Supreme Court decision from May 2019 that we had included and made reference to in that submission. The judge asked me to explain to L that the Upper Tribunal allows them to stop counting when they get to the 12 points needed for an award of the enhanced rate, and wanted her to know that this did not mean that they were dismissing her claim for additional points.

We were in and out of the hearing in about three minutes and you can imagine L's relief. Her sister said that she was afraid of dogs and had never touched one before, but she enjoyed making a fuss of Pebbles. I passed on the judge’s comments and we emerged into the North London sunshine for a photograph. My hope is that the increased benefit will make a difference in terms of transport to therapy as well as taking some pressure off with everyday expenses. L explained that there is something wrong with a recent ESA decision so it looks as if there will be another file to open, and the team has a new member, Pebbles the chihuahua.

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  • Questions asked at PIP assessment
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  • Section III: The PIP appeal process and alleviating your stress levels
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  • Section I: The PIP appeal process and alleviating your stress levels
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  • How Many Days?
  • No Need To Score Points To Be Successful
  • Personal Independence Payments (PIP) for over 65
  • Would The Ambulance Crew Make It In Time?
  • Personal Independence Payment (PIP) Descriptors
  • Personal Independence Payment (PIP) Points
  • Once, twice, three times a winner..
  • Rather more than we bargained for..
  • Twice in Inverness and both were allowed..
  • A very welcome shortcut..
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  • Client opted for a hearing without being there..
  • Now that’s what I call a reconsideration!
  • Persistence pays off big time
  • Can YOU wash your right arm with your right arm?
  • 15 Points for Mobilising and Support Group Placement

Categories

  • ESA Case Studies
  • PIP Appeals
  • PIP Articles
  • PIP Case Studies

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PIP Articles

PIP payments backdated

By DC-ADMIN | 18/11/2020
PIP Articles

Challenging a PIP tribunal decision

By DC-ADMIN | 31/10/2020
PIP Articles

How to do a PIP reconsideration

By DC-ADMIN | 31/10/2020
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Enhanced PIP Benefits

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PIP Articles

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PIP Case Studies

PIP Appeal in Sutton

By DC-ADMIN | 28/04/2020

Category: PIP Case Studies

PIP appeal hearing date arrives before the PIP appeal papers

23/01/2020 //  by DC-ADMIN

PIP appeal hearing date arrives before the PIP appeal papers

I wondered what I had let myself in for. Lee had been awarded zero points and lived alone, so must be managing in some form. He offered to set up a standing order towards the cost of his PIP appeal, but it was hard to see how he would manage this. Lee suffers with a combination of anxiety, depression, psychosis, PTSD and back pain. He had been first on the scene of a horrific road traffic accident and was plainly troubled by this, plus he had been raped while in prison, and life was clearly difficult for him, even with his two dogs for company. 

We were somewhat taken aback when the notice of hearing arrived in August because I had not seen appeal papers at that point, and neither had Lee. These are supposed to be supplied by the DWP and evidently the tribunal office had received theirs or the appeal would not have been listed. The tribunal clerk said that they could not supply me with a copy of their bundle and that I must ask the Department, which left me no choice but to request a postponement, with Lee’s agreement. 

Under pressure

Five weeks later, we were notified of the new date, in October, so the pressure was still on. When Lee and I had been through the PIP test, my advice was that he should have had awards of the enhanced rate of both components of PIP. We had a very brief hand-written letter from Lee’s GP, which was helpful. Talking to Lee about people I might take witness statements from, he gave me the names of four women; I am not quite sure why this came as a slight surprise. I ended up taking statements from three of them, but it was a male friend who came with us to the hearing in October. Most of my clients are up and down England so that contact is by email, phone and post, but Lee lived about 40 minutes from the office. I needed paperwork from him and there was not a day to lose, so I went round on my way from work. It was a filthy night and this was new territory for me, so I was glad of the Google directions through the bike headset. Finding a flat in a complex can be enormous fun, but for once I went straight to the right door. Lee didn’t have a lot materially and didn’t look to be in great shape, but he seemed pleased to see me for the first time, and his dogs looked happy too. 

Our case

We said in our written submission to the tribunal that there was a need for prompting with activities such as preparing food, taking his medication, washing, dressing, engaging socially and making budgeting decisions and there was support for this from the witnesses and a 2018 ESA assessment report. The tribunal understood this and we went from zero points to 13 for the daily living component. They understood about his anxiety too but it was clear to me during the closing stages of the hearing that they were only persuaded that he needed someone with him on unfamiliar journeys. This would have given Lee 10 points for mobility, so standard rate, but we wanted the enhanced rate, so we needed the tribunal to accept that there was also a need for that person when going to familiar places too. 

Thank goodness for ESA

The tribunal had not mentioned the brief ESA assessment report that we had sent in, which explained how he had qualified for the ESA support group. My last question to Lee during the hearing concerned what the nurse had written in her last paragraph about him being distracted by the voices and his thoughts, that he tried to concentrate but couldn’t. She went on to say that he cannot concentrate on anything and that it takes time to dismiss the thoughts and ignore the voices. This was written in April 2018, whereas the PIP tribunal had to look at how things were around the time of the decision in February 2019. I asked Lee to compare how these symptoms were affecting him during these two periods and how that distraction impacted on him crossing roads, even in familiar areas. Lee explained about the near misses, cars having to break and sound their horns, as well as being hit by a bus when he had tried to cross in the face of traffic. You could see that Lee’s point had hit home with the tribunal.

He got a five-year award of the enhanced rate of both components. Lee had felt bad about not being able to pay anything towards my costs as the work went along, and insisted on paying more than I had asked for. His arrears dated back to October 2018 and were quite substantial, partly because they eventually included severe disability and enhanced disability premiums on his ESA, also backdated to 2018. His weekly income went from £111 to £343. He planned to have fitted carpet in his living room. I never did find out why there was an extra 3p on the end of his transfer amount.

Recent Posts

  • PIP payments backdated
  • Challenging a PIP tribunal decision
  • How to do a PIP reconsideration
  • Enhanced PIP Benefits
  • PIP Claim – Change of Circumstances
  • What other benefits can I claim with PIP?
  • What illness qualifies for PIP?
  • PIP & ESA appeal over 29 months
  • PIP for Depression and Anxiety
  • PIP Appeal in Sutton
  • How long does it take to claim PIP?
  • Does Carers Allowance Affect PIP?
  • This PIP appeal in North London needed Pebbles help
  • PIP appeal hearing date arrives before the PIP appeal papers

Categories

  • ESA Case Studies
  • PIP Appeals
  • PIP Articles
  • PIP Case Studies

Archives

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The impact of Fibromyalgia on a PIP Claim

23/01/2020 //  by DC-ADMIN

The impact of Fibromyalgia on a PIP claim

The impact of Fibromyalgia on a PIP Claim is not the easiest thing to get accepted by the DWP.  Not that Tracey’s problems ended there; she is also affected by rheumatoid arthritis, hearing loss, depression, a heart problem and anxiety, all of which featured in her appeal. After going through the PIP test together, our advice was that she should have had awards of the enhanced rate of both components, so that is what we set out to prove. Tracey was one of the legion of claimants who lost a Motability car on the move from DLA to PIP. Her old award of high rate DLA mobility and lowest rate care component became standard rate of both components for PIP

The usual suspects

Tracey had scored 8 points for daily living, just enough to get standard rate. Those 8 points were the predictable Preparing food, Washing, Toilet needs and Dressing. Not awarding 2 points for Communicating verbally seemed very odd as she was wearing a prescribed hearing aid at the assessment. The fact that the nurse did not award those points or explain why she was not doing so, helped in undermining her opinions on other questions when it came to writing the tribunal submission. 

Evidence

We had a pretty basic letter from her GP, but also got hold of many pages of medical notes, which had to be read, noting where they supported what we were saying about Tracey’s entitlement. There are almost always unhelpful entries in such notes, so that a decision has to be made on whether to submit them or not, weighing the positives and negatives. We have seen appeals where clients have medical evidence, either thinking that it must help them, or not seeing how it would read if you were looking for a reason to turn the claim or appeal down. It has completely undermined what was otherwise a good appeal. The fact that the client disputed the negative entries did not help; they were there, and you will come across tribunals that are looking for reasons to say no, just as there are ones that look to see if any additional points should have been awarded. You never know what you are going to find when you walk into a tribunal room.

The impact of Fibromyalgia on a PIP Claim

Witness statements were taken from Tracey’s partner and sister, which were relevant and read well. From our experience, such statements are an under used source of evidence.

Evidence

We had a pretty basic letter from her GP, but also got hold of many pages of medical notes, which had to be read, noting where they supported what we were saying about Tracey’s entitlement. There are almost always unhelpful entries in such notes, so that a decision has to be made on whether to submit them or not, weighing the positives and negatives. We have seen appeals where clients have medical evidence, either thinking that it must help them, or not seeing how it would read if you were looking for a reason to turn the claim or appeal down. It has completely undermined what was otherwise a good appeal. The fact that the client disputed the negative entries did not help; they were there, and you will come across tribunals that are looking for reasons to say no, just as there are ones that look to see if any additional points should have been awarded. You never know what you are going to find when you walk into a tribunal room.

Witness statements were taken from Tracey’s partner and sister, which were relevant and read well. From our experience, such statements are an under used source of evidence.

17 days left

It did not help that this is how long we had from when Tracey first made contact, to the hearing date in Bolton, which had already been set. We are well used to working quickly and to a deadline, and wherever possible, we get the submission and evidence to the tribunal office in good time for them to get it out to the tribunal panel members. Great legal arguments, case law and evidence can be wasted if the tribunal have not had time to consider it properly. 

£300

Not our fee for the appeal, but this is what the client was able to put down towards that fee. Clients are often in difficult financial circumstances and may be dealing with the loss or reduction of their benefits. It can be tough to raise any money, but we do like clients to have a stake in their appeal. The rest of our fee only becomes payable if the appeal is allowed, so we have a stake in the appeal being allowed too as we would make a huge loss. 

The impact of Fibromyalgia on a PIP Claim

An anxious time

Tracey’s appeal for mobility was based in part on the Department having over estimated the distance that she could walk, but also on how limited she is in going out on her own. There are places she can go without another person, but there is case law on this, which we explained in our written submission, providing a copy of the Upper Tribunal decision to make it easer for all three panel members to think about. 

When we went into the hearing, the Judge explained that our appeal for 12 daily living points had been accepted on the strength of the evidence and submission we had put in. They accepted that additional points should have been awarded for the hearing aids, and for the aid provided by occupational therapy to help with cutting up food. The hearing then focussed on the two parts of mobility, with the client dealing with the questions really well. There was no Presenting Officer from the DWP on this occasion, but I do not believe that it would have affected the outcome. 

You can be pretty sure that a hearing has gone well, but you cannot be completely certain until you hear a decision announced, or see it in black and white. We knew that it had been allowed in part, with the Judge’s announcement on the daily living side, but they also added 10 points for Planning & following journeys, giving us enhanced rate of both, with a five year award, just what we wanted.

The arrears should come in at £4,200.

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Where do you find a decent pasty in Cornwall?

27/11/2019 //  by DC-ADMIN

Where do you find a decent pasty in Cornwall?

Can PIP Claim dreams come true among the spires of Cambridge_

K’s dad called me in January 2018 to explain that his daughter had scored zero points on her PIP claim. Her ADHD, learning difficulty and dyslexia clearly did not impress the assessor. After going through the PIP test, I advised that awards of the enhanced rate of daily living should have been made and the standard rate of the mobility component. I had K scoring 10 to 12 for daily living and 8 points for mobility.

We had to rely on a series of witness statements in the absence of medical evidence. Most of the witnesses were family, but we also had statements from a long-term friend and a social worker. Two of the witnesses spoke about K’s road safety, affected by her impulsive nature and poor concentration. As a result, I uprated our claim for mobility to 12 points and enhanced rate. This was on the basis that K needs someone with her, to allow her to safely follow the route of even a familiar journey. The appeal was first heard earlier this year and it went well. K was awarded the standard rate of both components, scoring 10 points for each. A very good outcome when going in with zero, make no mistake, but not the right one.

My advice was that we should attempt to challenge the tribunal’s decision and her dad agreed. We sent for a statement of the tribunal's reasons for their decision and this revealed what I considered to be errors of law. Our application for permission to appeal to the Upper Tribunal was considered by one of the more senior judges, who agreed that the first tribunal had given inadequate reasons the parts of their decision. Instead of sending the case to the Upper Tribunal, the judge set aside the first decision and directed that K’s appeal be reheard by a new panel.

The preparation had to be done again and one of the witnesses was out of the country this time. As luck would have it, the judge for the re-hearing was the same one who set aside the earlier decision. From the wording of her decision to set aside, it seemed to me that the judge was also wondering why some of Kay's points were awarded at all the first time round. That was spelt out by the judge at the start of the second hearing and only six of the daily living points awarded at the first hearing seemed to be fairly safe. Kay and her partner, in particular, did really well dealing with the questions from the three tribunal members and when we came out to await the decision, I was happy with the way things had gone. The Presenting Officer, there on behalf of the DWP, did make a couple of good points, but I did not feel that they had damaged us.

The trouble was that K and the witnesses did not think that it had gone nearly as well as the first hearing. They expected fewer, if any, points to be awarded. I make a note of the evidence given during a hearing, as the judge does, so I see less of the panel's reaction to the evidence as it is given, so I did wonder if I had misread the situation.

We did not have long to wait and the decision was on the desk when we went back in. The tribunal had awarded the enhanced rate of both components, dating back to December 2017. The award runs to December 2021, which makes sense as the hope is that a return to medication will at least make a difference. We got the 4 points that we wanted for Preparing food, because it was accepted that K was not safe with a sharp knife, and was too easily distracted during cooking. The accepted that 2 points could be awarded for Reading & understanding ‘complex written information’, and that K needed ‘social support’ to be able to engage with other people. We had wanted 2 points for Making budgeting decisions, but K’s evidence persuaded the tribunal that assistance is needed with even basic budgeting, which I had not included in our appeal. These took her score to 14 points; quite impressive when going in with zero.

Not only are the arrears payable back to 2017, but ESA will be asked to add both a severe disability and enhanced disability premiums to the calculation of their needs as a couple, and these too will be payable back to December 2017. 

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Can PIP Claim dreams come true among the spires of Cambridge?

14/10/2019 //  by DC-ADMIN

Can PIP Claim dreams come true in Cambridge?

Can PIP Claim dreams come true among the spires of Cambridge_

K’s dad called me in January 2018 to explain that his daughter had scored zero points on her PIP claim. Her ADHD, learning difficulty and dyslexia clearly did not impress the assessor. After going through the PIP test, I advised that awards of the enhanced rate of daily living should have been made and the standard rate of the mobility component. I had K scoring 10 to 12 for daily living and 8 points for mobility.

We had to rely on a series of witness statements in the absence of medical evidence. Most of the witnesses were family, but we also had statements from a long-term friend and a social worker. Two of the witnesses spoke about K’s road safety, affected by her impulsive nature and poor concentration. As a result, I uprated our claim for mobility to 12 points and enhanced rate. This was on the basis that K needs someone with her, to allow her to safely follow the route of even a familiar journey. The appeal was first heard earlier this year and it went well. K was awarded the standard rate of both components, scoring 10 points for each. A very good outcome when going in with zero, make no mistake, but not the right one.

My advice was that we should attempt to challenge the tribunal’s decision and her dad agreed. We sent for a statement of the tribunal's reasons for their decision and this revealed what I considered to be errors of law. Our application for permission to appeal to the Upper Tribunal was considered by one of the more senior judges, who agreed that the first tribunal had given inadequate reasons the parts of their decision. Instead of sending the case to the Upper Tribunal, the judge set aside the first decision and directed that K’s appeal be reheard by a new panel.

The preparation had to be done again and one of the witnesses was out of the country this time. As luck would have it, the judge for the re-hearing was the same one who set aside the earlier decision. From the wording of her decision to set aside, it seemed to me that the judge was also wondering why some of Kay's points were awarded at all the first time round. That was spelt out by the judge at the start of the second hearing and only six of the daily living points awarded at the first hearing seemed to be fairly safe. Kay and her partner, in particular, did really well dealing with the questions from the three tribunal members and when we came out to await the decision, I was happy with the way things had gone. The Presenting Officer, there on behalf of the DWP, did make a couple of good points, but I did not feel that they had damaged us.

The trouble was that K and the witnesses did not think that it had gone nearly as well as the first hearing. They expected fewer, if any, points to be awarded. I make a note of the evidence given during a hearing, as the judge does, so I see less of the panel's reaction to the evidence as it is given, so I did wonder if I had misread the situation.

We did not have long to wait and the decision was on the desk when we went back in. The tribunal had awarded the enhanced rate of both components, dating back to December 2017. The award runs to December 2021, which makes sense as the hope is that a return to medication will at least make a difference. We got the 4 points that we wanted for Preparing food, because it was accepted that K was not safe with a sharp knife, and was too easily distracted during cooking. The accepted that 2 points could be awarded for Reading & understanding ‘complex written information’, and that K needed ‘social support’ to be able to engage with other people. We had wanted 2 points for Making budgeting decisions, but K’s evidence persuaded the tribunal that assistance is needed with even basic budgeting, which I had not included in our appeal. These took her score to 14 points; quite impressive when going in with zero.

Not only are the arrears payable back to 2017, but ESA will be asked to add both a severe disability and enhanced disability premiums to the calculation of their needs as a couple, and these too will be payable back to December 2017. 

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Can you work full-time and have a substantial PIP award?

14/10/2019 //  by DC-ADMIN

Can you work full-time & have a substantial PIP award?

Can you work full-time and have a substantial PIP award?

The Department did not think so; a score of zero points did not look promising.
Steve did a reasonable job with his claim form in August 2018. The medical
evidence he sent in with his reconsideration request was not that helpful. He suffers with degenerative disc disease, sciatic pain and reduced sensation in some areas, linked to the nerve problem that begins in his spine. His employer
has been really helpful, creating a new policy that allowed him to work from home
on a regular basis, which reduced his commuting.

No change at the reconsideration stage, but no surprise there. We had a couple
of quite good medical letters, but naturally these were not able to comment of the
activities that were appealing about. For that we used a series of witness
statements, from his wife, friend, work colleague and his manager. There was
some contradiction across the four statements, but I do not see this as a bad
thing in itself; it may actually help in terms of credibility and the weight that can
be given to the contents. Because of his back problem, we wanted 2 points for
the need for a seat for preparing and cooking food.

Steve does not have any proper aids in his home but uses the sink to help into the over bath shower.

We said that in the alternative, there was an issue over motivation and the need to be prompted. Again, no aid for helping him up from the toilet, but he uses a nearby cabinet and we argued that this was being used as an aid.

Like many of us, he needs to sit down to dress, but unlike many of us, he then needs to use a piece of furniture to get back to his feet. In the early days of PIP, the use of a seat for dressing was accepted by the Upper Tribunal as scoring 2 points for the need to use an aid/appliance, but sensibly, this is not now the view.

Many people who do not have an illness or disability need to sit down for aspects of dressing. We successfully argued that if a claimant needs to use something to get back to their feet, then that can be classed as an aid and score 2 points.

This was supported by case law on what constitutes an aid. Inevitably, the pain that Steve lives with has affected him emotionally as well, and we argued that part of that impacted on his ability to engage socially.

For mobility, he is very restricted. We argued that 1 to 20 metres applied, either in terms of distance or because the pain that he walked in spite of was such that
he was not walking ‘to an acceptable standard’, applying the PIP regulations and case law, which we also sent in ahead of the hearing.

I was expecting Steve’s appeal to be listed in about February 2020, so was surprised at it coming up this September. It left us a bit of work to do, but everything was ready for the hearing, with our submission, the case law we were referring to and those witness statements lodged in good time.

We all had to do some serious waiting at the venue as we went in 50 minutes late. Perhaps you can imagine the extra pain that Steve was suffering, but at least this was clear to the panel. We were in there for a full hour, but he dealt with the questioning very well. Because the tribunal members had to get lunch before starting their afternoon list, we had to leave without knowing the outcome.

My feeling was that we had done enough to get standard rate of both components, and enhanced rate mobility, with a bit of luck.  I was extremely pleased to read the decision when it arrived; standard daily living and enhanced rate mobility, dating back to July 2018, so a really useful amount of arrears, and a substantial contribution to the household income going forward. The award is for just two years, which is quite unusual, but the tribunal must have considered that something is likely to change in that period; let us hope that it is for the better.

My advice is that he and I should put our heads together over the renewal claim when the time comes.

In the meantime, another great team effort.

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PIP Appeal Tribunal Awarded Six Times The Number Of Points Awarded By The DWP

01/08/2019 //  by DC-ADMIN

PIP Appeal Tribunal Awarded Six Times The Number Of Points Awarded By The DWP

Diana telephoned on 6th June to explain that she had a hearing date in Preston on 19th June for her PIP appeal. With just 9 working days between then and the hearing, I did consider whether the right advice would be to request a postponement but concluded that there would be enough time. Work began that day going through the PIP test together to establish how she should have scored additional points, and my advice was that she should have had awards of the enhanced rate of both components.

On the days that followed, we went through the assessment report together, after receiving the appeal bundle by post, finding a significant number of misunderstandings, omissions and errors. I was then able to put together a submission for the tribunal and the first part of this explained what was wrong with the Department’s assessment and why the tribunal should not rely on it. The second part of the submission set out in detail where Diana should have scored additional points and why, explaining how our view was supported by the legislation, PIP regulations and Upper Tribunal case law. I enclosed one of the Upper Tribunal decisions that I thought was particularly relevant. I took a witness statement from her daughter and after she approved the draft version, all our written evidence was emailed to the tribunal office, seven days before the hearing.

Diana's husband and daughter attended the hearing to support their witness statements and Diana did particularly well with her evidence. Everything seemed to have gone well but since the tribunal opted to put the decision in the post, rather than announce it on the day, the outcome could not be taken for granted. I got a call from Diana on the Saturday following the hearing to explain she had scored a total of 36 points, a massive improvement on the 6 points awarded by the Department. Out of the 14 points scored for the daily living component, eight of these came from preparing food, which I was particularly pleased about. The tribunal went on to award 10 points for Planning & following journeys and 12 points for moving around and the icing on the cake was that their award was not for a fixed period, so is ongoing.

I have seen arrears paid within a matter of days of a hearing, but this appears to be rare. I generally advise a client that they should expect 4 to 6 weeks and allowing six weeks, Diana's arrears period amounts to 67 weeks. Taking the April 2019 uprating into account, her arrears should amount to £9780, quite a good return on her fixed fee of £2685. It represents 27% of her arrears, justifying our reluctance to charge a percentage of a client’s arrears. Diana’s ongoing four-weekly payments will be £595. A good outcome.

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A Good Outcome, With The Client Receiving Exactly The Award We Wanted.

01/08/2019 //  by DC-ADMIN

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

Diana and her husband live in Suffolk and came to us for help with the move 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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