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Some quick advice on PIP tribunal please
A client had her PIP tribunal on Friday. The client suffers from fibromyalgia and Raynaud’s which causes intense pain the majority of days to the extent that she generally cannot get out of bed. She also suffers from mental health issues including depression, stress and anxiety. The pain is mainly in her left side (chest, shoulder, arm, hand) and she cannot move her left arm at all due to pain. She was awarded 6 points by DWP for activities 1, 4 & 6 for needs to use an aid. Her husband cooks all of her evening/weekend meals and makes her sandwiches to eat when he is at work. As she cannot move her arm she cannot cook, bathe, dress etc and he helps her with all of these activities. She has memory issues and he sorts all her medication into a dosset box and calls her to remind her to take them. She also struggles to communicate with people due to her depression and will not leave the house unless accompanied by her husband.
I argued that she could not undertake the majority of tasks as she is unable to use her arm and rarely gets out of bed because movement itself causes intense pain.
She is receiving counselling by a mental health practitioner at home and has tried self-harming in the past.
The tribunal itself was held in a court room with the panel up 2 levels where the judge would normally sit. Right from the start the lady was in floods of tears and could barely communicate as she felt she was on trial.
Her appeal was refused and I have asked for a statement of reasons. The whole process has worsened her mental health and I feel conducting the tribunal in those circumstances with a lady that has mental health issues was wrong. Is there any way of raising a formal complaint about how the tribunal was handled? Any thoughts on the decision would be appreciated as well.
First post. Welcome.
Numerous aspects to cover but let’s give it a shot.
1) Get your statement of reasons and record of proceedings and make that the main focus of a further appeal.
2) Tribunals are increasingly held in court rooms thanks to the need to make savings on venues that were previously exclusive to the Tribunals Service. They can appear more formal than of old but it’s not necessarily the case and you have no real comparator unless your client has previously attended an appeal hearing in a more formal venue and was fine. I’ve sat in a portakabin room run in a manner way more formal than a court and vice verse.
3) Tribunals ideally don’t want to be up on the dais but it’s often unavoidable and criticism of that needs to be tempered with some knowledge as to why. It’s worth talking to a venue clerk about that before acting. There are a small number of tribunals who see their role as being above but in the overwhelming majority of cases it’s more to do with the only way into the court lead them to the dais, or, a member having a disability that would prevent their being located elsewhere.
4) Playing devils advocate - She has Fibromyalgia. There is a perspective that says it amounts to little more than undiagnosed symptoms thanks to a differential diagnosis. Has she sought a second opinion? Was she prepared for the fact there would potentially be some scepticism about that? Raynauds is generally fingers and toes. How does that relate to an entire arm? Is that credible? The lack of use of one arm seems unlikely with Raynauds unless she completely neglected it (which of course could be linked to her mental health) and in any event would not necessarily prevent certain activities being performed albeit that it may impact on reg 4 and reg 7 issues e.g. whether she could complete an activity in a reasonable time. The links between emotional stress and Raynauds are known but the fact she attended the appeal hearing suggests some of her issue could be around motivation because of mental health. Ultimately, I think we’d probably need to know much more precisely what the case was as the picture you’ve painted, albeit on limited info. thusfar, could potentially be interpreted as a client who is complaining of a vague set of symptoms no-one can diagnose. Where diagnosed they may lack credibility. She could also be perceived as having a propensity to lack motivation to do things rather than an inability to do things, and that might include acting in her own best interests to get further help. Depression, stress and anxiety can feed into that but are often used inter-changeably and often self-diagnosed. What’s her precise diagnosis? What are her meds? Who is she currently seeing if anyone?
As I say, I am playing devils advocate. What you’ve described so far seems well within the range of reasonable responses for a tribunal. A bit more detail may paint a very different picture. I do appreciate there are sometimes circumstances where you’re not always able to provide that. I hope you can.
5) It does sound to me as though you had a client who would have been emotional and distressed by the experience no matter what the venue and the location of the tribunal and possibly no matter what the outcome. None of that means the tribunal have done anything wrong. The reps. role is to ensure that the client understands fully, or as much as is possible, what will take place. What they will be asked and what it will be driving at. If a tribunal member was rude; said something racist, sexist etc. or plain old outrageous then you have a complaint. If not then it may be worth taking a step back.
Anyone else?
“anyone else”
yes me. agree about getting SoR etc
but more fundamentally, on the Raynaud’s, which is my specialist field in its guise of VWF/HAVS. I’ve seen loads of cases, at various stages of severity, and sometimes combined with CTS or some other upper limb condition. And i have it myself, as it is is also caused by Rheumatoid Arthritis, amongst other things.
Raynauds, as Phil said, does not affect the arm in its entirety. it stops the blood flowing properly to the fingers (the medics think) but then only when it is cold. can sometimes affect the feet, as stated. but it would never prevent movement of the arm
so you may well find, when you get the SoR, that the medical person discounted this as being in any way relevant.
“anyone else”
Raynauds, as Phil said, does not affect the arm in its entirety. it stops the blood flowing properly to the fingers (the medics think) but then only when it is cold. can sometimes affect the feet, as stated. but it would never prevent movement of the arm
so you may well find, when you get the SoR, that the medical person discounted this as being in any way relevant.
Did Phil say that or me? “Confused face”.
Anyway, thanks Claire. Nicely summarises my concern here. Three main conditions:
- Fibro - up there with CFS for being dismissed by the majority of medical professionals who sit on tribunals.
- Raynauds - symptoms not consistent with what we know of the condition.
- Anxiety, stress, depression - no detail.
If that’s what there was then I would guess it didn’t play out well. Over to Phil for more detail maybe.
To be fair, Phil didn’t say the client couldn’t move her left arm due to the Raynauds. He said she had Raynauds and Fiibromyalgia and couldn’t move her arm due to intense pain (which could be a related to the Fibromyalgia).
I would certainly be seeking leave to appeal to the UT if the SOR indicates that the medical member had discounted Fibromyalgia as being a ‘real’ illness (especially if there was evidence in the bundle to confirm the diagnosis and- ideally- the effects). However, as you say., we’re straying into conjecture here.
Agree with the other points raised.
Just to add that, whilst Mike may be correct insofar as why HMCTS use court venues for hearings, that doesn’t mean you cannot or should not complain about the venue if you feel it was inappropriate or unsuitable. In fact, I would positively encourage making complaints in such circumstances, otherwise things will never change.
How to make a complaint about HM Courts and Tribunals Service
We can help with complaints about:
* the way your case was handled by our administrative staff
* the facilities at our venues
Just to add that, whilst Mike may be correct insofar as why HMCTS use court venues for hearings, that doesn’t mean you cannot or should not complain about the venue if you feel it was inappropriate or unsuitable. In fact, I would positively encourage making complaints in such circumstances, otherwise things will never change.
How to make a complaint about HM Courts and Tribunals Service
We can help with complaints about:
* the way your case was handled by our administrative staff
* the facilities at our venues
Seconded.
sorry, you’re right, he didn’t say that about the raynauds….
and you know, if she in fact cannot use the arm, is there something else going on that hasn’t been investigated because her GP has assumed its all the fibromyalgia?
Hello all,
Thank you for the response.
The lady has been undergoing tests for 17 years and was originally diagnosed with thoracic Outlet Syndrome. This has now been discounted. She was diagnosed with fibromyalgia in 2008. The pain can start at any time and be anywhere in her left side. Just because the medical profession isn’t clever enough to diagnose the problem, doesn’t mean it’s fictitious. I have known this lady for a long time and have seen the problems she has. She has continually worked since leaving school but as her condition deteriorates she can do less and less. I’ll update you once I have the statement of reasons.
Thank you for the help in the meantime.
Re: the tribunal sitting at a raised dias. This was an issue for us when our venue moved to the local Magistrates Court, and is precisely the kind of issue for which Tribunal Users Groups were invented. We had problems with the new venue placed on a TUG agenda, and managed to negotiate the use of a couple of tables placed at the end of the courtroom, as well as the use of a curtain to cover over the dock. We also secured the use of a private interview room for reps and their clients, away from the very public court waiting area.
Our venue moves again next month. I only hope we don’t have to sort these issues out all over again.