Dec 172015
 

People who make a claim for PIP normally undergo a medical assessment (carried out by Atos or Capita, commercial contractors). If not, their claim is assessed based on the merits of the medical evidence and the PIP form they have sent to the assessors.

Let’s not forget that assessors only make recommendations. It is the Department of Work and Pensions Decision Maker who decides to award PIP to a claimant. But assessors do have to make recommendations which will influence the duration of the PIP award. Contrary to what is generally assumed, assessors do not make a recommendation for the duration of the award. They only recommend the date for a PIP review.  This recommendation will take into account whether a claimant’s condition is likely to improve or worsen, or whether a claimant has been awarded the highest rate and the medical condition in unlikely to improve. In the latter case, the award period will be of at least 11 years or indefinite and there will be no review date. This should be mentioned in the PIP award letter:

“All awards must be reviewed, as your condition is unlikely to change I have selected the maximum possible review period.”

For all other PIP claimants, the assessors will have recommended a date for a PIP review. When the Decision Maker receives this information from the assessors, and enters it in the computer, the duration of the PIP award is automatically generated as follows:

‘Awards

Where an award is made, the CM {Case Manager is the name given to DWP Decision Maker for PIP} must include the “Date of assessment” and “Review Period”. This will generate a review date and end of award date. The “Review period” is the period of the award up to the date the award review is planned for which will normally be the date recommended by the AP. You can enter “Indef” or a number of years/ months, as appropriate. The “Review period” generates the “Award end date” which will be indefinite or one year beyond the “Review date”.’ https://www.whatdotheyknow.com/request/263680/response/648138/attach/3/DMR%20Template%202015%20User%20Guide.pdf

 

Let’s say an assessor recommends that a claimant should have a PIP review in 2 years time. Once this information is entered in the computer by the Decision Maker, the claimant will automatically be given a PIP award for 3 years. The letter informing a claimant of a PIP award should mention the PIP review date, but it is done in such a way that many claimants are not aware of a PIP review, nor of what it entails. Claimants assume that they have been awarded PIP for the duration mentioned in the DWP letter, but in fact this duration is equal to the duration of the PIP award minus 1 year.

The terminology is also confusing as it seems that a PIP review is very similar to a new PIP claim or a reassessment, when the claimant has to fill in the PIP2 form. The only difference seems to be the reason why it is happening.

But there is also a very nasty, vicious regulation, Regulation 11, which gives the Secretary of State the authority to determine afresh whether a claimant still qualifies for PIP, for any reason and at any time.  https://www.legislation.gov.uk/ukdsi/2013/9780111532072/pdfs/ukdsi_9780111532072_en.pdf

 

Re-determination of ability to carry out activities

‘11. Where it has been determined that C {Claimant} has limited ability or severely limited ability to carry out either or both daily living activities or mobility activities, the Secretary of State may, for any reason and at any time, determine afresh in accordance with regulation 4 whether C continues to have such limited ability or severely limited ability.’

So it seems that the Secretary of State ha the authority to request a PIP review at will. The guidance is a bit clearer about this:

‘This is a key piece of information not fully covered in the system notifications so should be included in the reasons so the claimant knows we’ve not specifically targeted them for planned award review action. This doesn’t stop us choosing to review the case before this date but this would only be where we receive new information or the law changes’.  

So although a PIP review can be done at any time during the duration of a PIP award, it would seem that there should be some justification for it, either because new information has been received, or because of a change in law. Although far from being clear, it would seem that the decision to review a PIP claim could be legally challenged, if there is no basis for the review, and if there is reason to believe that DWP is punishing or harassing a claimant who has, for example, made a complaint. As it has not been tested in court, it is difficult to be certain, but the bottom line is that claimants should know that their PIP claim will be systematically reviewed one year before the end of their award.  This information should be clearly mentioned in the letter they received informing them of the duration of their award. And they should challenge DWP if no review date has been mentioned in their letter but they are called for a review.

This post will be updated as more information becomes available.

 

 

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 Posted by at 13:43

  8 Responses to “Important information: When a PIP award is not what it says on the tin”

  1. I have had a copy of my pip assessment and got no points, but then I got review date 2 years can anyone help. I have not had my decision yet. I wish i never asked for copy as they have by my calculation gave me nothing worried is not the word pls pls help me

  2. I read exactly the same sort of circumstances for my wife in amongst what I read about you good people. My wife has a condition which will not get better – in fact it’s got significantly worse over the last 21 months. So (you’ve guessed what’s coming I’m sure) they’ve effectively knocked £50pw or thereabouts from her allowance. One would only need to ask her doctor or see the list of medications to see there is a major health problem. We truly believed that the payments were totally on-going.

    I don’t need to tell you about the stress, I’m sure…

  3. Tweeted @melissacade68

    Also; I’ve just completed what is a migration from DLA to PIP before my DLA was due for renewal (apparetnly they can do that(?)) it NEVER gets any easier filling in DWP forms.

  4. I’ve yet to be transferd from dla (lawarded for life)to pips….dreading it. However I successfully challenged the farcical “assessment” by Atos RE ESA and with informative articles like like this I hope to be able to navigate the sheer hell of pips and all its obfuscation. Thanks DPAC.

  5. i have been awarded pip ongoing because my illness is for life it has no review date on, but was told ongoing was for 10 years, should they have put a review date on the letter.

    • This is the same with me. I did have a ‘provisional’ date of 11 years though on the phone it’s labeled as indefinite.

  6. Wife was awarded SDA ( supposedly for life ) in 2002
    WAS SENT es50 a month
    AND IS Awaiting assessment by Health Advisory Service ( Maximus)
    It appears that if she fails the assessment that in all likely-hood she would be straight
    Onto JSA

    no PIP
    ———————

    • I went from SDA to ESA50 form worrying & worrying, it came back in a month ESA Support with a note I was under claiming on my DLA for some six years so they got that sorted (new DLA form although) to high care/mobility. All without ever once seeing any doctor nor assement. Try not to worry, if the medical evidence is strong & clear she should pass though automatically like I did some 6 years, however although awarded indefinite on DLA & ESA they phone MY GP once every 3 years whom makes it very plain the only medical assement she will accept from them is in her room or In my home with her present as the nearest centre is too far for a collapsed spine to travel there and back in 1 day (20/30 mile round trip)

      Despite this the move WAS VERY SLOW and was underpaid for 8 months as they forget to inform HMRC that I was know due tax credits (family & SDA shortfall allowance) so watch out for tax credits, by law the DWP has to tell HMRC although when they fail they expect YOU to make fresh claim for TC but I invoked MP power ((now de-seated conservitive MP), one term failure McCloud)

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