In my last post I talked about my experiences with the mental health services and that my mental health had taken a dive.
Well, part of the reason for the dive will be explained in this post.
Please bear with me as this will be a fairly long post.
I have mentioned benefits assessments and issues on this blog before. I’d now like to share my experience of claiming personal independence payment (PIP) and the switch from disability living allowance (DLA). If you are in the UK, you might have heard of these benefits for ill people and some of you will probably have experiences with DWP (department for work and pensions) and their assessments.
I had previously been awarded DLA in 2012 at low rate care and low rate mobility. In December 2014 I had another assessment done and was awarded middle rate care and low mobility for 10 years (indefinite award) due to my issues with OCD. Both of those assessments did not require a face to face assessment and were done on paper.
In March 2016 I was told that I had to apply for the new benefit PIP and that if I didn’t apply, my DLA payments would stop in a month.
I made the initial phone call to PIP and got the ball rolling. This meant that DLA would continue until DWP had made a decision whether to award PIP or not. I would now have to wait for the application form/assessment form to be sent out to me.
The form arrived a few weeks later and I started to read through the various questions regarding preparing food/cooking, washing and bathing, dressing, socialising, walking distance and planning/undertaking a journey.
I decided that I needed help understanding and filling in these forms so I made an appointment at my local citizens advice bureau (CAB). Unfortunately, the appointments they could offer me were outside of the 1 month timescale which DWP give you to return the forms. I was able to get a 2 week extension which meant I could go to the appointment and then return the forms to DWP within the extra 2 weeks.
I decided to pick my friend up on the day of the appointment so that she could come with me and also add anything which I may have missed (and meet my family).
We went to the appointment and it all went very well. The advisor was lovely, filled in the forms and copied them for me and even sent the form off to DWP on my behalf.
About a month later I received a letter from ATOS (the assessment firm contracted by DWP to do medical assessments for PIP and ESA benefits) asking me to attend an appointment at a nearby assessment centre.
The assessment took place in June and the assessment centre was over 200m away from the nearest public parking.
I had asked my ex-foster carer to attend with me so that I had someone with me as I do not do unfamiliar places very well.
We arrived in good time, signed in and sat in the waiting room for the assessment time which was 10am. Luckily, there was no one else in the waiting room so my anxiety wasn’t as high. If there were other people in there I would have had to have waited outside as I can’t deal with busy or crowded places.
I was called in to the assessment room which was not much bigger than a small office and had a desk with a computer and a few chairs in.
The assessment started and the assessor introduced himself and said he was a mental health nurse. I was asked the usual sort of questions about my illness and how it affects my day to day activities.
Once the assessment was complete, I was told that the report would be sent to DWP for them to make the decision and I would hear something back in roughly 4-6 weeks.
2 days after the assessment I received the DWP text message stating that they had received all the information needed to decide my PIP claim and that I’d receive a letter once a decision had been made.
I contacted DWP a few weeks later (towards the end of June) to ask for a copy of the assessment report. They allowed the report to be sent to me and it arrived a few days later.
When I opened the report, I went straight to the last few pages. These pages are where the assessor ticks a box (descriptor) and allocates points based on which box they had ticked. I knew straight away from looking at those descriptor boxes that I would not be successful and my claim for PIP would be turned down. This would mean that my DLA would stop 1 month after the DWP had made their final decision.
On further reading of the report from the assessor, I noticed that there were some contradictions in the descriptors. One example was that the assessor had ticked the “no help needed” box but in the reasons box he had written about the help I did need for that particular activity.
There were also some things missing which I had stated in the assessment as well as on the initial application form.
In mid July, the dreaded DWP brown envelope dropped through my letterbox. I had been unsuccessful in my claim, scored 0 points across both sections and my DLA would stop the second week in August.
Just like DLA, PIP has 2 different awards. 1 is for daily living (care on DLA) and the other is for mobility (getting around and planning/undertaking journeys). There are also 2 rates for both of those components with PIP. For standard daily living, 8 points are needed across the daily living section and for standard mobility you need 8 points from the 2 questions in the mobility part.
It wasn’t just about losing the extra money from DLA. DLA affects ESA (Employment and Support Allowance) too. By losing DLA and not being awarded PIP, I would be losing a premium on my ESA award known as the severe disability premium (SDP). My housing benefit would also be affected (lowered) as the rules for housing benefit changed some years ago. If you are under 35 and living alone, you can’t claim the rate for a single bedroom property. You are only entitled to what is known as the shared accommodation rate which is a lot lower than the rent allowance for a single bedroom property.
An exemption to the under 35 rule is applied if you live alone and receive middle rate care (DLA) or standard daily living (PIP) components of the qualifying benefit.
This rule had applied to me for 18 months due to being in receipt of middle rate care component of DLA.
This would mean that from my reduced ESA, I would have to pay 1/3 of my weekly income towards the rent and still keep up with paying the bills and buy food.
Now the fight with DWP begins and I have to appeal the decision.
The first stage of appeal is to submit what is known as a mandatory reconsideration (MR). This means that you can request that your claim is looked at again by a different person (decision maker). There is a timescale of 1 month from the date of the decision to do this.
Having the report from the assessor made this easier for me. I was as able to pick apart the report and outline various aspects which were incorrect.
Once again I contacted the CAB for advice and assistance in submitting a request for a mandatory reconsideration.
An appointment was arranged and I went to it with the information from the assessor report and the points I was arguing against.
The form was filled out and a letter outlining my issues with the report and the decision was sent back to DWP at the end of July 2016.
A few months went by and I had not heard anything from DWP regarding my mandatory reconsideration request. I contacted them several times to ask for an update but was told that it had not been looked at yet and there was no set timescale for reconsiderations to be looked at.
At the start of October, another of the dreaded brown DWP envelopes was pushed through my letterbox. Once again the decision was not to award PIP to me. The reasons for not giving an award were exactly the same as the previous decision letter. It felt as if they hadn’t even read the letter I included with the request for reconsideration.
I had been doing some research into PIP and the criteria for an award. This included a breakdown of each question and the points which could be awarded for each activity such as preparing a meal, washing and bathing, dressing etc. I knew that I fitted several of the criteria required for points to be awarded for some of the questions.
So now my only option is to apply to the tribunals service to appeal the DWP decision not to award PIP to me. Once again I would only have 1 month to do this.
At this point I decided to ask my local MP to get involved. I sent them copies of the DWP letters, the assessment report and a list of the points I believe I should have been awarded, which included a breakdown of each part of the report.
I also sent copies of the list of points to the tribunals service as well as a breakdown of how my illnesses affect me daily.
The MP sent a letter to the tribunals service stating that my illnesses were genuine and did have a profound impact on my day to day life and activities.
With my appeal date approaching, I contacted my GP surgery to ask for my records. Once I had obtained the medical records, I sent them to the tribunals service to ask for them to be included as evidence in my case.
The day of the tribunal arrives in mid May 2017. Once again I decide to ask my ex-foster carer to attend with me. This was for 2 reasons 1: so that she could provide some support for me and help ease my anxiety due to being in a strange place with strange people and 2: so that she could provide some input at the end of the hearing. My foster mum knows me better than anyone and has seen the struggles I go through.
We travel to the place where the appeal hearing will take place and find somewhere nearby to park. At this point I still had my vehicle on the road so I drove. Luckily we were able to park just across the street from the court.
We enter the building and are asked to empty our pockets and be subjected to a metal detection scan. We sign in and are told to go to the second floor where we would be met by the clerk to the tribunal.
When we get to the second floor, the waiting room is tiny and is packed with people. I had asked the tribunal to allow a separate space for me to sit but this hadn’t been put into place. I had to try and find a small space in the corner to sit whilst waiting.
The clerk to the tribunal comes across and introduces herself. She then goes through what will happen in the appeal and also tells me that the medical evidence I had sent to the tribunals service had only been received by the appeal panel the day before. She also told me that the panel decided to go ahead with the appeal knowing that they had not had sufficient time to go through my medical records. She also told me that a representative from DWP would be present in the hearing.
We are finally called through to the hearing room. Now this isn’t like a courtroom, it’s just a large set of tables in a room with the 3 panel members sitting at the other side. The 3 panel members are a judge (sat in the middle), a former GP or medical professional and also a disability specialist.
The hearing lasted about 40 minutes or so and I was asked various questions relating to my illnesses. This seemed to focus on my ability to prepare food mostly, one or 2 questions about my ability to go see my friend 2 hours away and how I do my food shopping.
Unfortunately, the disability specialist was trying to understate my issue with cooking and contamination. I was asked almost the same question 3 times regarding my decontamination rituals (which I have mentioned on a few previous blogs). Then, she tried to put ideas in my head and said why would I need to scald items if they had already been washed in hot water. She didn’t understand that washing items to me is not enough to ensure a contamination free piece of cutlery or a pan.
The DWP representative seemed to be more focused on my claim for ESA rather than my appeal for PIP. He asked several questions relating to ESA and being in the support group and did not ask any questions relevant to my PIP application or appeal.
Once the hearing had finished and they had asked all the questions, we were asked to go and wait whilst the panel discussed my claim and their decision.
Whilst the panel were discussing things, we popped outside for some air. When we came back upstairs, we were told that the panel couldn’t decide at that time and I would receive their decision in the post within a few days.
The appeal took place on a Friday in mid May. The next day the tribunal decision dropped through my letterbox. Once again I had been unsuccessful and the tribunal had decided that I should be awarded 0 points in all areas. This was despite having relevant medical records and letters/reports from therapists within the mental health services.
Unfortunately now there is not much that can be done. The DWP decided I’m not eligible for PIP (twice) and so does a tribunal. This is despite the tribunal having the relevant medical evidence and the letter of support for my case from my MP.
There is only 1 final course of action that I can take and that is to seek legal assistance in my case and appeal to the upper tier of the tribunals service.
Unfortunately this is quite difficult. You can only appeal to the upper tribunal if there has been errors in law relating to the case.
The first stage is to write to the tribunals service to request something called a statement of reasons from the tribunal judge. This statement of reasons (SoR) states why points were not awarded. You only have 1 month from the date of the appeal decision to ask for this.
I requested the SoR from the tribunals service. It took about a month for it to arrive.
Now I had to try and find some form of legal assistance to see if there were any errors in the tribunal decision. . Unfortunately, legal aid is only available if the upper tribunal accepts an appeal request. I had to find some other way of getting help to appeal the decision made by the tribunal.
I contacted my local MP’s office again, told them what had happened and asked if there was anything they could do to help me appeal the appeal decision.
The only thing that they could do was to refer me to something called the bar pro-bono unit. This would mean that someone would take on the case free of charge but it would be a long process. I only had 1 month to launch an appeal and there was no way that someone could be found within that time.
I notified the tribunals service that I was wanting to appeal the decision but was awaiting assistance to help me go through the paperwork so that any errors in law could be identified.
Towards the end of August 2017, I received a directions notice from the tribunals service which was signed by the judge from the appeal. This directions letter stated that they knew I wished to appeal, however I must set out the grounds for my appeal and that an extension would not be awarded in order for me to obtain this help. The letter also stated that I must send detailed accounts of the steps I have taken, when I had taken them and then a decision would be made on the merits of admitting the application late.
Unfortunately at this stage I was unable to provide the information they required. An application to the bar pro-bono unit had only just been submitted and that was all I could have done.
A month later, another directions letter from the tribunal judge arrived. Unfortunately this letter stated that as no valid application had been made for appeal to the upper tribunal, no further action would be taken by the lower tier tribunal and the paperwork would be marked for destruction.
After several months of sending this information to the bar pro-bono unit, I received a reply. They had accepted my case and were now waiting to see if someone would take my case on.
We are now into November and I still hadn’t heard anything from the bar pro-bono unit so I decided to see if there was a local charity or law centre which could provide some assistance. Unfortunately, the local disability charity couldn’t help as they hadn’t been involved in the original appeal.
I had found a number for a law centre in the next town over from me (my town doesn’t have one) and contacted them to ask if they could offer any help. They stated that they had someone there who dealt with disability appeals and disability law.
I received a call back the next day from someone at the law centre. I spoke to the nice chap and explained the situation to him. He said that he would like to have a look through my case and asked if I could possibly send him the appeal pack with all the evidence, tribunal notices and decision letters.
Unfortunately, photocopying over 150 pages would be costly so I spoke to the bar pro-bono unit to ask for them to send the documentation to him and to also close my case with them. The bar pro-bono unit agreed to close my case and send all relevant documentation to the gentleman from the local law centre.
The week before Christmas I received another letter from the tribunals service stating that they had received an application for permission to appeal to the upper tribunal against the original tribunal hearing.
It was decided that a new tribunal should hear my appeal and that the application did not need to be considered by the upper tribunal. The original tribunal decision of May 2017 would be cancelled and a new hearing would be arranged in due course.
I was quite surprised by this letter as I hadn’t sent the tribunals service any requests to appeal. The gentleman from the law centre had looked through my files and drafted an appeal request on my behalf. Once I knew this, I contacted him and asked if he could possibly send me a copy of the appeal request.
He sent me an email containing the letter he sent and it made some good reading. Not only did it contain my points for appeal, it also stated that the tribunal had breached disability law by not making reasonable adjustments where necessary to enable me to seek the assistance I required. The letter also stated that they had breached this law when sending out the directions notice because they had not included any timescale to submit the relevant information to the tribunal.
I was given a new tribunal hearing date (April 2017) and I sent a few other pieces of evidence to the tribunals service which included a copy of my previous DLA award (the DLA files had been destroyed) and also a brief statement from my latest ESA assessment which stated that I had severe OCD and that it had an intrusive impact on my ability to function.
The day of the tribunal arrives. I had asked my ex-foster carer to come with me once again as she had been with me throughout the PIP process. Unfortunately I was unable to drive this time as my car had been off the road for almost a year at this point. This was due to not having the money to be able to keep it running due to the loss of the DLA and the ESA disability premiums.
My foster mum drove us there and we were able to park across the road from the court.
We went into the building and had to again go through the process of signing in, emptying our pockets and going through the metal detector (the handheld one, not a full scanner like at an airport).
We were instructed to go up to the second floor again where the tribunal clerk would see us.
Now, here’s where the experience changed. This time we were greeted by the clerk and, as requested, we were moved into a small room at the side of the waiting area. This was the first positive, they had listened and adapted to my needs due to the contamination fears.
The clerk came in and sat down and again explained the appeal process and who the panel would be. Now we just had to wait to be called.
We were called in a few minutes later and it was in the same room as the previous hearing. Sat in front of me were 3 new panel members who were willing to listen to me discussing my mental health and my claim for PIP. The panel judge also stated that this was a completely new hearing and anything from the previous hearing (SoR etc) would not be used. There was also a DWP representative sat on the same side as us.
After about an hour and the end of the hearing, my foster mum was able to say a few words about me and how things affect me. Once this had been done, the hearing was adjourned whilst the panel discussed my case and made their decision. We were asked to leave the room whilst this process was going on so we decided to go get some fresh air. I then bought my foster mum a coffee from the machine whilst we waited.
After about 15 or so minutes, the clerk came over to us and called us back into the room. There on the table where I had been sitting was a piece of headed paper with the decision.
When we sat down I didn’t want to read the piece of paper. I was preparing for another failed attempt at claiming PIP.
The judge then told us her decision and the reasons why.
Finally after 20 months of going through the PIP application process, the mandatory reconsideration and 2 appeal hearings, I had been successful. I had finally been awarded something.
The decision actually came as a shock to me. Because of the issues I have with preparing food, washing and bathing and socialising, I had been awarded 12 points in the daily living section and the award was for 5 years (until August 2021). This 12 points meant that it was an enhanced level award. I wasn’t awarded anything for my mobility issues because I can go out, I can make journeys and I can walk. Being honest, I was just grateful that the whole thing was over. Being awarded anything was just a big relief.
When we left the court and were returning to the car, I was in tears. The fight was over for another 2 and a half years (although I am concerned I may have to fight when it comes to ESA).
I was crying tears of joy. I think my foster mum may have also shed a few tears for me.
The DWP could appeal this decision in the same way I had by finding an error in law.
Now comes the good part. Because the DLA had stopped in August of 2016, PIP should have been awarded from the day after the DLA ended. Because I had to appeal etc, no payments had been made. The tribunal decision overrides the original DWP decision from July 2016 and meant that PIP should be paid from August 2016. This meant that DWP would have to pay the claim from that date and would result in a large sum of money being paid to me for the period that PIP was not paid.
Also, because of PIP now being awarded, the severe disability premium for ESA should be reinstated, as should the single bedroom rate of housing benefit. This would also mean that there would be some money due to be paid back to me from ESA and housing for the period where it was not paid.
The PIP department from DWP contacted me about a week after the appeal hearing asking for my bank details. This meant that they would not be appealing the decision and they would pay the outstanding money to me. Being honest, this was really quick and the money would be in my account the following week.
Now things get a little complicated with the housing benefit and ESA.
The disability premium of ESA had been paid to me for 6 months after my DLA had ended. This was an error on DWP’s part as they had not been notified that the DLA had ended. Once they were notified that PIP was in payment, the premium was reinstated and they were going to backdate the payments to when the DLA stopped. Unfortunately, this would have resulted in an overpayment as 6 months of it had already been paid to me.
I had to contact ESA and explain that their figures were incorrect and that an overpayment would result if they issued the full amount. It was passed on to a supervisor to investigate and a few days later they got back to me stating that I was correct and that they had amended the payment for the period and it would be paid into my account the same day (which it was).
The issue I had with ESA also applied to the housing benefit. When they were notified that PIP was in payment, they were going to issue the money to me. However, they had calculated in the same way that ESA had and were going from the date the DLA ended and not the date that they stopped paying the single room rate. Once again it would have resulted in an overpayment. Housing benefit had already tried to claim this money back from me the previous year but, upon further investigation, it was deemed as their error and it was written off, meaning that I would not have to pay anything back. This was due to the fact that I had notified them the month before the DLA ended and explained to them that the DLA was ending and PIP would not be paid.
It took the housing benefit department a week to finally figure out that I was correct and they would indeed be making an overpayment to me if they didn’t recalculate the benefit from the date they started paying the lower rate.
They issued the payment but made another mistake. Instead of paying me the whole amount back (which I had requested), they split the payment and sent most of it straight to my landlord (my housing benefit is paid directly to the landlord due to financial issues 5 years ago).
I then had to contact my estate agent to try and recover the rest of the money from them. This process took 2 days but finally I had all the money owed to me from PIP, ESA and housing in my account.
After spending nearly 2 years of only just getting by, I was now able to start paying bills fully again. I would finally be able to get back out on the road and I would finally be able to go see my friend again and do things for myself. I would no longer have to rely on family to take me to the shops to get food in as I would be able to put my car back on the road or find another (newer) one to replace it.
Going through all the above did have an adverse effect on my mental health. I was worried about not being able to pay bills, I couldn’t go out anywhere unless someone took me and I couldn’t see one of my best friends who understands my issues. In fact, during the period between June 2017 and May 2018, I barely saw anyone. The only time I saw people was when my foster mum took me shopping or I popped across to see them when other family members visited (mum and sister).
I’m sorry this post was so long but I had to let you all know what had been happening and let people read about my experiences with claiming PIP.
Thanks for reading and I hope to start writing here more.