My letter to the DWP about PIP (as copied to Heidi Allen MP)
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PIP application : Mandatory reconsideration - My letter to the DWP
(as copied to Heidi Allen MP)
(as copied to Heidi Allen MP)
[Address redacted – as
further redactions are noted]
Personal Independence Payment [X]
Post Handling Site [Z]
[Town
Postcode]
21 December 2017
Dear Sirs
[Redacted : name – date of birth – National Insurance no.]
PIP application : Mandatory reconsideration
I write further to your letter dated 6 December, whose box was too small to give many and varied reasons why a mandatory reconsideration should make a different decision from that dated 18 November (which, probably over-elaborating*, I am attempting to set out in the separate document enclosed – this and it are watermarked with my name and NI number, in case any pages become detached).
In addition, I was due to see Dr [X], my usual GP at [Z] Surgery, on Friday 15 December, and I write in the light of seeing him and his agreeing to write to you in support. (However, I believe (from having contacted the surgery’s reception), that he has still to complete and send his report.)
I enclose, therefore, my detailed submissions (with reasons) why the decision should be reconsidered in my favour (awarding me at least the Standard rate for Daily Living), together with a copy of an annotated version of the letter dated 12 October 2016 that I received from [Z] Partnership (NHS) Foundation Trust (ZPFT). As mentioned further in those submissions, I discussed the letter with Dr [X] near the time, to decide with him whether it was worth my while to try to push to be granted a service more similar to what I had asked for. (An unannotated copy of the original of this letter was shown and given to the assessor, but it is not listed, and likewise others, on the Consultation report form PA4, on page 1 – ‘all evidence considered’.)
Recent chronology :
* Monday 6 November – appointment with Dr [X], who had not been asked for a report, and who read and then was supplied with copies of the PIP application form (in readiness)
* Tuesday 7 November – the postponed medical assessment in [Z] (after one had been cancelled on the day)
* Saturday 18 November – date of decision (which was slow to arrive [sc. because the DWP bulk-uses a private co., UK Mail, which then provides it to Royal Mail to be delivered with the ordinary stamped or franked post])
* Monday 27 November – called DWP (on [no.]), and spoke to [Y], with whom an hour-long telephone conversation ensued (for a summary of the essential points of which, please see below)
To begin with, I set out the following matters in this covering letter as being, in my opinion, of general application, and so – by copying this letter to my MP, Heidi Allen, by e-mail – I am asking for her to raise them with the relevant Minister(s) of HM government. I do so on behalf of all who have – on the phased ceasing of DLA (Disability Living Allowance), which is itself an inequity (although one from which I have benefited, by not having to go through this process before this date) – been obliged either to forgo such a payment, or apply ‘to transfer to’ PIP (Personal Independence Payment). There are also those who, unwittingly, freely choose to apply, but with inadequate information.
On 27 November, I made the phone-call, as it seemed implausible that Dr [X] could have been asked to write and have written a report in the timescale given above, i.e. an assessment on Tuesday 7 November, and the decision already made and sent out on the second Saturday succeeding it (18 November). As I told [X], the DWP representative to whom I spoke, the decision had been skimmed through, but it did not appear to mention a report from Dr [X]. She confirmed that none had been asked for, and that – with a discretion whether to do so – Independent Assessment Services (though still not wholly effective in a name-change from Atos) – usually do not request one (or words to that effect – she may have said ‘normally’, or ‘ask for’).
On my own behalf, and having had to seek to assist clients […], I knew that the application form for other welfare benefits preceding PIP (e.g. DLA, or even IB (Incapacity Benefit)) contained the same sort of boxes for name, address, telephone number, etc., of health and other professionals. However, there was the legitimate expectation, because of what the practice was, that medical reports would be obtained, by or on behalf of the DWP – i.e. as part of the process of (re)applying for the benefit.
In other words, as an individual, the claimant did not previously have to arrange for this to happen – obviously, any existing medical evidence, in letters or reports, could be submitted, but he or she did not have to commission his or her own up-to-date report (and meet any fee for writing it ?). Such existing reports were anyway unlikely to address the specific day-to-day needs in the way that those application forms asked for (or that for PIP now does) : the objectiveness of the assessment is supposedly predicated on its descriptors and corresponding points (as against wordings to fit into under the criteria for DLA, mobility and care components), but assessors, in a rather facile way, pick on what is evident and undeniable to them. (For example, how I am described, at the top of page 10 of the form PA4, under ‘General appearance and Informal Observations’ – one is credited for some of what one says by what the assessor can observe or witness, but not for others.)
The fact that this is even so is an inequity, both for those less confident of being able to persuade a reluctant, because busy, GP or specialist to write a report – as against a request by or for the purposes of the DWP, which carries official weight – and / or for those without the means to pay for one (de facto they are, after all, applying for welfare benefits).
1. The DWP sends out a fact-sheet that (starting with returning the form) leads up to information about the medical assessment, and refers to the role of Atos. However, as I wish to point out to Ms Allen, as my MP (and for everyone’s benefit), it needs to be absolutely explicit : in this benefit application (unlike others that a claimant may have made, before PIP), the onus has now actually been put on the claimant to obtain – if it does not already exist, in current written form – any additional evidence or information from the professionals who support you that explains how your condition or disability affects your daily life. (Also enclosed, attached to this letter, is a copy of that fact-sheet, where I have marked the sections that I am quoting.)
2. At some level, that may seem clear enough, but the following sentences (after skipping the next one) must be read as well : Please send the most recent evidence you have that shows how your ability to carry out the activities we ask about in the form are affected by your condition or disability. Only send in photocopies of things you already have available to you [my emphasis]. (On the reverse of the sheet (under ‘Evidence that will help us to assess your PIP claim’), it even refers to what will assist a claim (Reports about you from […], followed by a list of eight types of professional, including GPs, consultants (‘hospital doctors’), and physiotherapists.)
3. Arguably, when coupled with the following factors, it is not clear enough to anyone making an application that reports will not be asked for, but that they are likely to be needful (please see para. 4, below) :
(a) The fact that the initial application for PIP takes place by telephone, and therefore the DWP could take responsibility – in that call – for being plain with claimants that Atos (as [Y] informed me on 27 November) use their discretion and, by and large, do not request reports (or even tell claimants that they have not requested them),
(b) At odds with what I was told by [Y], the fact-sheet goes on to say (under ‘What Happens Next ?’), when the claim has been passed to the assessment providers (i.e. Atos), They may ask the professionals who support you for extra information if they need it, and
(c) Somewhere, between the DWP and Atos, any fee that might have been paid to GPs or others to write reports that were previously requested directly has then probably been pushed in the direction of the claimants (although, by definition, they are applying for welfare benefits), as well as putting on them as patients, etc., the task of trying to get someone to write reports (unlike a GP, etc., having a formal request from, say, the DWP)
4. If all of that is the case, and if it were also fair and right for it be so, it cannot be fair or right not to spell out to claimants, when they make the telephone application, that they have to commission (and pay for) the reports that may assist their claim, i.e. a reasoned account from a professional that explains how your condition or disability affects your daily life. Unless a claimant has had a needs-led assessment, or input from an occupational therapist, it is not likely that a report will happen to cover his or her ability to carry out the activities we ask about in the form (ten activities for Daily Living, plus two for Mobility).
5. Unlike in my case (where I was being obliged to make a claim for PIP by a specified date, because DLA would otherwise just finish), someone who did not want to be rushed with an important application (as it is by definition intended to try to make their life better financially), could then exercise the decision to delay making it – to have the best chance possible with it, by giving him or her time to obtain a report (and, additionally, the funds for any payment for writing it). In such a case, that person should properly be told, at that stage, what position he or she is in, because, by delaying making the application until he or she knew that a report was going to be available (and what cost would be incurred), the chances of successfully claiming would be increased.
Conclusion
I can therefore see no reason why that is not an important and mandatory element, in the early part of the call (before starting the application itself), when someone telephones to make an application for PIP (or in the information sent out). It should then be followed up with an absolutely clear written statement of the same (whether or not, in that same call, the potential claimant proceeds with completing the application process).
In the enclosed submissions (which have taken me, on and off, since around 8 December (or before)), I turn to the particular matters raised by my own case – the PIP decision dated 18 November, and the Consultation report form (PA4), dated 7 November, on which it is based. As mentioned above, I also refer to the annotated letter dated 12 October 2016 from ZPFT (Z Partnership (NHS) Foundation Trust) (the original of which was sent in with my application for PIP, and referred to in the assessment, but not acknowledged on page 1 of the PA4), and one of the DWP fact-sheet (attached hereto).
Please acknowledge safe receipt of this letter and its enclosures. I look forward to hearing from you.
Yours faithfully
[Claimant]
cc Heidi Allen, MP (via heidi.allen.mp@parliament.uk only)
* As shown by the appended e-mail exchange, I had been waiting to hear from [X] (at [Z] Council, and who met me to complete the PIP application, in her handwriting, but with my answers). When I did receive this e-mail, and then sent her what I was then working on here (and in the enclosure), I seemed to have no reply from her, so I have had to press on, without her assistance :
Appended e-mail correspondence
RE: PIP decision
Thu, 14 Dec 2017 9:37
[Sender]
To [Claimant]
Apologies for the delay. Please send over your response and I will be happy to ‘edit’ if necessary
From: [Claimant]
Sent: 10 December 2017 22:20
To: [Recipient]
Subject: PIP decision
10 December 2017
Dear [X]
After you helped me with the PIP application form, and I then managed to avoid having to go to [Z] (and getting stressed in a place that I barely know - though, oddly, that is so narrowly defined in the descriptors for 'Making and following a journey'), I forgot about your covering letter, when you posted me the scanned form.
It re-emerged, when I was looking for the copy PIP form earlier to-day. An appointment, in [Z], was cancelled on the day, when my friend [/ …] and I had already arrived. They let us rebook it for Tuesday 7 November, and they issued the decision really quickly - I had seen my GP on the day before the appointment, shown him the forms and the descriptors (as he had not been asked to write a report), and made him copies of them.
When I got the decision (dated 18 November), I did at least receive 6pts (but still 2pts short), and I was quickly on the phone to them for an hour, berating them that, when they know that people want their medical evidence considered, they (or the assessors) do not even tell people whether the assessors used their discretion about whether to request it (apparently, they do not normally request it).
Which means that the claimant is unaware that it will not be to hand at the time of the assessment. That is just wrong, when their decision claims 'This information is the best we have available...'. I said that I would complain to my MP, and that the DWP - commissioning the assessment services - cannot claim not to know what is in their standard letters to claimants. What do you think ?
I am writing something to argue myself up the necessary 2pts. Would you be willing to take a look, to temper the enthusiasm of someone arguing his own case, when I have finished ?
I am seeing the GP on Friday - they are giving him till 25 December to write in support.
Best wishes for Christmas
[Claimant]
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