PIP Appeal problem (UK)

[Wonko]

A few months ago I filed a PIP appeal, largely on the basis of a deeply flawed medical, and asked for a paper hearing.

This morning I got a letter back saying that it had been adjorned and asking for me to send them permission for them to obtain my medical records from 2016 to now.

The problem is I haven't seen my GP in over 2 years, the only medical things I have had have been the odd hospital visit for my type 2 diabetes, which simply isn't relevant to my PIP application, or appeal.

As far as I am aware I may still have the option of an oral hearing, but I would rather not do one because I tend to come off as too healthy, and my cognitive problems cause me to just gloss over, forget or omit things, yet I come across as fairly bright and with it, at least to those who want to see that.

Because I've been ill for so long (28 years) I consider a lot of things normal, so don't mention them etc. Or alternatively I mention things, and then more things, and then more, and it all sounds so unbelievable that someone could live like this with no medical intervention.......I've been here before (not with PIP) and I know how people react.

Part of my case, a lot of it in fact, is down to problems caused by aspergers/cognitive impairment, now I can, to limited degree, eventually solve most problems I encounter, it just takes me a long time, at times I can even talk to people in a relatively normal way, for a few minutes. This is not normality these days, it's a mask I put on, when I have the resources to do so. Or extreme need.

I am concerned that this is what will happen at the tribunal if I attend, they will think I am trying to pull a fast one, which is one of the reasons I asked for a paper hearing in the first place. It's what happened at the PIP medical, although I would hope the tribunal panel wouldn't be as biased.

However, it they were satisfied with my case, which as far as I am concerned is pretty ironclad, for the way the system is marketed as working, then they wouldn't be asking for additional medical evidence, which I don't have, and they know I don't have because I told them in the paperwork.

Attending an oral hearing is likely to make me even more ill, for a few months, and I'm not exactly on top form ATM.

So....what do I do?

 

[ladycatlover]

Might be worth contacting Fightback via their Facebook page? Not sure where you are in England, they are near Bury. They have a free visit day on October 4th. If you are too far away to visit them they can help and also fill in forms over the phone. It was thanks to them that I went from low daily living and moving around to high level for both at Tribunal. Good luck, whatever you decide to do.

PS I sent the Tribunal a copy of all of my medical notes since 1992 when I first got sick - it was about 145 pages! When I went in the Judge said "we know an awful lot about you."

 

[wastwater]

Hi,I think in law if you have an autistic spectrum condition they must supply help and support,financially as well.
They may just want to see you're diagnosis
I was in the same boat I went to a oral hearing and got flattened,no award
I did paper appeal and got award
In some cases it's not always best to go in person ie if you have a communication disorder
Officially they do say in person appeals have a better success rate but that is an average

 

[Wonko]

Hi,I think in law if you have an autistic spectrum condition they must supply help and support,financially as well.
They may just want to see you're diagnosis
I was in the same boat I went to a oral hearing and got flattened,no award
I did paper appeal and got award
In some cases it's not always best to go in person ie if you have a communication disorder

I would doubt there is one in my medical records, as it was obtained from an individual my GP sent me to for advice as, apparently, it is impossible to get an ASD diagnosis as an adult in my area. The DWP have however never contested the diagnosis, or the route it was obtained by, in fact it was the sole route that was used to place me in the support group by one of their doctors in a targeted medical, with a note that I was unlikely to improve enough to leave the support group.

But.....I probably don't have this in my medical records, although they (the appeals service) were sent a copy of that ATOS doctors report.

Rock....Hard place.

 

[wastwater]

You can get an official diagnosis but it costs about 1k plus,the NHS funded mine
Digby tantum from Sheffield has a company and there are others too
I can retrieve the names of the one in Preston/lancashire and the one at Yorkshire clinic/bingley if you're interested and in those areas

 

[Esther12]

Generally, people seem to do better with in person tribunals (there is data showing a really significantly higher success rate). If you don't have medical evidence from a supportive medical professional, it could be especially difficult for you to succeed via a paper hearing. In your form, did you explain that (and why) you'd not attended your doctor about CFS for the last couple of years? If not, that could hurt your case too.

I don't know what I'm talking about, and would suggest you seek advice from someone who does, but I'd be leaning towards trying to attend the tribunal if I were you (and if you need the money enough to make the burden of this worthwhile).

Rock....Hard place.

Yup. Good luck.

 

[Invisible Woman]

Might it be worth checking with your GP practice to see if the person who diagnosed you with Asperger's also wrote to your GP? It is customary that a note would be sent back to the referring GP - which doesn't mean it happens of course.

If Fightback aren't able to help (I've heard good things about 'em) maybe the CAB can?

Whatever route you end up going down: paper/ in person, I think it's worth making sure they are aware that most pwME don't go to the docs, as when they are ill in addition (virus etc) to ME they are too sick to go. Most of us don't go routinely because there's no point & the place is full of sick people & we don't want to catch anything else.

It's certainly worth reviewing your entire case with someone to see how best to proceed.

Fingers crossed for you.

 

[Wonko]

If you don't have medical evidence from a supportive medical professional, it could be especially difficult for you to succeed via a paper hearing. In your form, did you explain that (and why) you'd not attended your doctor about CFS for the last couple of years? If not, that could hurt your case too.

Yep I did, hence my above reference to already having told them Specific note of it was made in the appeal submission papers, in a few places, as I see the DWP's case being entirely based on the word of a paramedic who clearly had no understanding, or desire for any, of any of my conditions or how they affect me.

I'll obviously have to give it some thought, fried right now, due to the letter turning up earlier, and having to exert myself to fix some plumbing (kitchen sink, been partially blocked for weeks, tried to fix it before but unsuccessfully and decided I couldn't put it off any longer, kitchen is unusable right now so looks like tea isn't happening tonight).

I'll give their letter a re-read tomorrow, as i was only able to pick up bullet points earlier and my brain just ain't up to the job right now.

Thank you everyone for your advice, I've got to attempt to drop this for now or go non functional, which I can't afford to do.

 

[Invisible Woman]

 

[charles shepherd]

In addition to the advice already offered…

Some basic information on PIP applications, paperwork, medical assessments, reconsiderations and appeals from the MEA:

1 Notes on House of Lords meeting with Dr Ian Gargan, Chief Medical Officer at Capita, to discuss DWP medical assessments:


http://www.meassociation.org.uk/2016/10/pip-medical-assessments-with-capita-meeting-at-house-of-lords-next-tuesday-21-october-2016/

2 PIP checker from the DWP

The DWP has produced a useful website checker that you can fill in to find out if you can claim PIP and what will happen if you apply for PIP
You can use this tool to check:

• if PIP affects you or someone you care for
• how PIP will affect your child
• when you can make a new claim for PIP or you are transferring from DLA to PIP

https://www.gov.uk/pip-checker



3 FILLING IN THE APPLICATION FORMS


We have a very comprehensive MEA guide to filling in the PIP application forms
The MEA guide goes through ALL the PIP questions and how to answer them in relation to ME/CFS
It also emphasises some of the key points that we have been discussing with the DWP in relation to PIP - eg that you are able to carry out the activities being assessed in a way that is reliable, repeatable, safe to yourself and others, and carried out in a timely manner

People have found this guide to be very successful in relation to obtaining this new benefit

MEA guide to PIP and other DWP benefits:
http://www.meassociation.org.uk/shop/benefits-leaflets/


4 ATTENDING A MEDICAL ASSESSMENT

The CAB have a very useful guide to all aspects of the medical assessment with Atos, Capita or Maximus:
https://www.citizensadvice.org.uk/b...p-with-your-esa-claim/esa-medical-assessment/

If you are unable to travel to an assessment centre, the medical assessment can be carried out out in your home.
Contact the assessment centre, explain your situation, and obtain written support from your GP if there is a reluctance to do a home assessment.

Please note that this assessment is not carried out by the DWP - the report on your condition is then sent to the Decision Maker at the DWP


5 RECONSIDERATION PROCESS

If your application has been refused there is an initial mandatory reconsideration process

6 GOING TO APPEAL

In relation to an appeal, there are several things people can do to increase the chance of winning an appeal. These include:

a Obtaining good supportive (written) medical evidence to support your case. In relation to PIP, this can come from people involved with your care (eg a care or social worker if one is involved) and any health professional who is involved with your care (eg OT, physio, nurse) in addition to your GP and/or consultant
b Turning up in person at the appeal
c Getting feedback from people with ME/CFS who have been through the appeal process - you could do this by using MEA Facebook where we have over 6,000 regular members who are always willing to pass on this sort of practical feedback

7 USEFUL VIDEOS

In addition, this is a useful source of information on preparing for an appeal from the MInistry of Justice:
http://hmctsformfinder.justice.gov.uk/courtfinder/forms/sscs001a-eng.pdf

This video, made by the Ministry of Justice with an introduction by Dr Jane Rayner, Senior Medical Adviser, First Tier Tribunal. Dr Rayner is a very kind and helpful doctor whom I have met at the House of Lords, is also useful - although it refers to ESA:

Minutes for meeting at House of Lords with Dr Rayner:
http://www.meassociation.org.uk/201...-me-group-minutes-of-meeting-26-january-2011/

Dr Charles Shepherd
Hon Medical Adviser, MEA

 

[justy]

@charles shepherd - the pipchecker link above doesn't work- it takes you to a general page, from which I cannot find the pipchecker.

 

[MeSci]

@charles shepherd - the pipchecker link above doesn't work- it takes you to a general page, from which I cannot find the pipchecker.

It works now.

 

[charles shepherd]

It works now.

Try this MEA link if you are still having problems linking to the official info from the DWP:

http://www.meassociation.org.uk/201...s-a-website-checker-to-help-you-20-july-2016/

 

[Luther Blissett]

For a paper hearing, having access to all the info the DWP hold on you might be useful.

You can make a request for the data using their forms here https://www.gov.uk/government/publications/dwp-request-for-personal-information

You might (probably will) have to pay a small fee for it.

If there is information that the DWP has already accepted as good enough for an eariler point in the claim, in theory they should have new evidence if they want to challenge it (to be seen as reasonable). If you met descriptors earlier in time in order to have a successful claim, what evidence do they have that things have changed?

 

[Wonko]

If there is information that the DWP has already accepted as good enough for an eariler point in the claim, in theory they should have new evidence if they want to challenge it (to be seen as reasonable). If you met descriptors earlier in time in order to have a successful claim, what evidence do they have that things have changed?

I have all the info they have sent to the tribunal, which appears to be all the info I have supplied in relation to this claim plus the PIP assessment report, it all appears complete (144 pages) but there doesn't seem to be any additional information.

I was on DLA, this is PIP, and the ATOS ESA medical report was for ESA (although I did use it to bump my DLA up a level).

As far as I am aware they (the DWP) don't need to provide justification as PIP is a different benefit with different descriptors, the fact I am at least as disabled as when I was awarded DLA and so need the same or greater support doesn't seem to matter to them. They have stated in the "History" that I was on DLA MC/LM.

Having re-read the letter it appears they are asking me to attend the tribunal, and that they want my medical records from 1/1/2016 (which won't tell them anything useful to my case) and any consultants records from 2012 onwards (which may cover my MCI diagnosis, I'm not sure), if I don't reply giving them permission within 2 weeks, and don't also tell them I will attend within 3 weeks, then my appeal will proceed as a paper hearing.

Which on the face of it, is what I asked for, but with the additional suggestion that despite everything I've submitted they don't consider that my case currently outweighs that of the DWP's paramedics report, so it's likely I'll lose, but even though my case seems strong to me, that I more than meet the criteria for an award, I suspected I would lose anyway.

The suggested court is "local", it can probably only be 1 of 2 places, both of which I have been to. before (1 about 10 years ago, the other 20+ years ago), within a 15 minute taxi ride for either. A problem is that currently I have no one to go with me, which given I have stated that I cannot go to unfamiliar places, even local unfamiliar places at all, and am not predictably/reliably safe outside on my own, even going to familiar places, would probably present a problem in the eyes of the panel. The above is true, obviously I have to do such things, but it's not safe, for myself or others, for me to go out alone.

Just musing - sorry.

 

[Invisible Woman]

Muse away.

I find musing helps as you have to put your thoughts in some sort of order to discuss ' em and that, in itself, is helpful.

If you do decide to try to go in person then I would definitely either contact the CAB to see if they can help & send someone with you or contact the DWP asking about accommodation for the fact you cannot go alone. If you go alone having said you can't....

If you do go down the paper appeal route make sure you cite that as one of your reasons. Put it in writing.

 

[Wonko]

Muse away.

I find musing helps as you have to put your thoughts in some sort of order to discuss ' em and that, in itself, is helpful.

If you do decide to try to go in person then I would definitely either contact the CAB to see if they can help & send someone with you or contact the DWP asking about accommodation for the fact you cannot go alone. If you go alone having said you can't....

If you do go down the paper appeal route make sure you cite that as one of your reasons. Put it in writing.

Since my earlier post today I have spoken to my friend, it has been decided that I will give permission for them (the tribunal) to have access to my medical records, that I will not be attending, even if that means I lose (costing me around £140p/w (60% of my income not including rent) between what I was getting on DLA and SDP - although as my ESA payment hasn't dropped, they may still be paying SDP), and that an additional submission to the tribunal clarifying/restating why I will am unable to attend and why there will be a null result from my medical records.

And then just sit back and wait for the appeal denial letter

Live is too hard ATM to worry about things I probably can't change, especially when the most obvious attempts to affect change are likely to be counterproductive, and damaging to my health.

 

[Luther Blissett]

Don't be sorry for musing mate.

It's a highly stressful situation I know.

Sorry that I didn't make my opinion clear, but I was trying to reassure you from the viewpoint of a more neutral person than the DWP.

I'll try and express my opinion succinctly;

What do we know for a fact?

• Tribunals are fairer towards claimants than the DWP
• Tribunals are more reasonable than the DWP

My opinion;

• Tribunals often ask for a lot of paperwork, but this does not mean they believe one way or another, they just have to cover everything to make their decision correct in law, and avoid giving the DWP room for appeal.
• I know someone who presented evidence to tribunals. (not evidence to medical ones, but a different area) He left the DWP, in part because he was a fair person, and would help claimants claim what they were entitled to, help them fill in forms properly, etc. He hated what it was becoming. He has always told me that he was impressed with the impartiality of the tribunals, including the doctors and civil society representative, who was usually a member of a Trade Union. I trust his judgment, and have heard similar from reading about claimants experiences.
• You are being asked to do something you feel is unsafe, and bad for your health. Going to a tribunal does not necessarily mean that they will find that if you attend this means that you have no problems going to strange places, meeting strange people, etc. I don't know for PIP, but the words repeatably, reliably and safely are important. I expect that it is similarly true, if not the exact words. People often go into burning buildings, but this does not mean it is a safe thing to do in the judgment of a reasonable person.
• The tribunal is much less likely to take the opinion of this paramedic as infallible as the DWP are. A doctor might not view the paramedic as being that knowledgeable about long term chronic conditions, as that is not their area of expertise.
• Allthough it sounds scary, a tribunal is less like a court as we see them in the media, and more like a very formal chat. I've read many stories of claimants being surprised by how fair they were, how the questions asked allowed them to explain their situation properly, and the general feeling that the tribunal was willing to weigh the evidence much more fairly than the DWP. It is the first time in many claims that a neutral person with medical knowledge looks at the claim.
• If you do attend, it might be worthwhile asking what reasonable adjustments can be made for you under the Equality Act.

Sorry for presenting another wall of text for you to wade through, just want to try to provide you with a bit of support.

If your sink is still clogged, a mixture of baking soda and vinegar might do the job, here's a link with an explanation of how to try it. http://tipnut.com/tips-for-clogged-drains-homemade-drain-cleaner-recipe/

 

[Invisible Woman]

I understand. Don't forget they want people to give up.

That's why I would consider carefully any thing that will help you case now.

If you regret your decision later then it'll be all the more difficult to fight back.

This is one of the real evils of the current system. Pushing ill people to make themselves even more sick.

 

[Wonko]

@Luther Blissett

My sink appears to now be clear (thank you), at least it no longer takes 20 minutes for a few inches of water to drain. I'm 51, sorted blocked pipes and toilets etc. as needed before yet I had to google how to use a plunger correctly this time

My first, and second, and third attempts over the preceding weeks didn't work, including plunging, caustic soda, hot water etc., so yesterday I bit the bullet and emptied the cupboard, removed the shelf (not as easy as it would seem) and removed the u bend. The u bend was clear, the pipe behind it was clear. So I reassembled everything, tested it for leaks, didn't leak but still blocked, went to empty the bowl I'd put under the pipework and found a seal. So pull everything apart again, figure out where the most likely place the seal was from, and put it together again.

Of course now the problem is, why did it block, and did I force the blockage into the washing machines waste spur, is that actually done correctly (a few months ago I replaced an open downpipe which was far too short and overflowed* with a closed spigot based setup - so potentially lost air equalisation on that spur, which comes off the sink waste pipe in the main plumbing).

So...still unanswered questions, and was left with the kitchen in an unusable state, with no resources to sort it, or do much of anything else, which I cleared this morning. Ended up with cornflakes and a corned beef and pickle sarny for tea/supper last night.

Tiny, tiny little issues can be sodding huge things

*edit - been a problem for years, overflows into a cupboard, I didn't have the capability to do anything about it, or even realise I could, until a few months ago, just ignore it, or mop it up, containers under the pipe didn't really work coz of the amount of water. It needed doing, may not have been the best way but......

For any kitchen fitters passing, washing machines seem to need a standing pipe that is longer than 8 inches out of the u bend