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PIP renewal
Customer had award of PIP Daily Living Component Standard Rate and Mobility Component Standard Rate until 17/05/2016.
Following an early renewal form and F2F assessment on 23/07/2015, a decision letter was issued ending her entiltement to PIP from 06/08/2015 some 9 months before her award was due to end.
Is this a correct decision and what part of the legislation allows this? We have made a formal complaint on the customers behalf as well as asking for Mandatory Reconsideration as her health condition has in fact got worse and she is now undergoing specialist neurological investigation.
We too have a glut of PIP renewals coming through, all not due to expire for 12 months time. Have not had any decisions yet. We were wondering about the possibility of PIP being ended before the current award date. Now we know, as in above post, that losing the award is possible.
The most alarming thing is the letter states if you don’t return the form in time the award stops automatically, even if it has another 11/12 months to run - or so we thought.
Belt and braces needed / weapons grade approach to renewals and proof of postage mandatory.
Customer had award of PIP Daily Living Component Standard Rate and Mobility Component Standard Rate until 17/05/2016.
Following an early renewal form and F2F assessment on 23/07/2015, a decision letter was issued ending her entiltement to PIP from 06/08/2015 some 9 months before her award was due to end.
Is this a correct decision and what part of the legislation allows this? We have made a formal complaint on the customers behalf as well as asking for Mandatory Reconsideration as her health condition has in fact got worse and she is now undergoing specialist neurological investigation.
It’s a Social Security Act 1998 section 10 decision, but the Secretary of State must make out his ground.
Thank you nevip.
I have just looked at CDLA 14895/1996 which states that if there are no grounds for reviewing the existing award a renewal claim should be treated as having been made only on the renewal date.
What grounds would the secretary of state need to show to review an existing award? If it is a Secretary of State decision would the only redreess be by Judicvial Review?
I don’t think that judgment helps you. It’s pre the 1998 act for starters. Reg 11 Pip Regs allows a DM to re-determine a person’s Pip award at any time. The re-determination itself appears capable of being the change of circs required to supersede, ie there’s no additional requirement to show that the claimant’s condition has improved. Once a DM decides to make a fixed term Pip award authorised by section 88(2) WRA 2012 the provisions for renewing that award appear similar to DLA. For instance, Reg 33(2) & (3) Claims and Payments Regs 2013 allow, in effect, a renewal claim for Pip to be made within the 6 months before the expiry of the existing award and for any renewed Pip award to commence the day after the old one ran out.
These letters being received by clients upto a year in advance of the expiry of the Pip fixed term award do not appear to be invitations to renew although I’ve not seen one. Instead, they appear to be re-determinations of entitlement made on the DM’s own initiative unrelated to renewal.
Of course, just because a new determination can represent a change of circs doesn’t mean that the reasons why the original Pip was granted are irrelevant. On appeal, you’d be arguing that the conclusions of the original DM were more accurate than the superseding DM’s.
For appeal today I have detailed the PIP journey for my client for them to consider in the hope of getting some sort of determination from HMCTS regarding the ridiculous situation where this person spent so long going through the process that he had the PIP in payment for less than 5 months of a two and a half year award. He sent in a GP letter with the ‘planned intervention’ PIP2 that clearly shows his conditions were deteriorating and further complications developing.
‘As a result of his declining ability to care for himself and get about the appellant was advised to make a claim for PIP in July 2013. He then waited almost nine months before a face to face consultation took place. After a further two months he was informed that he was not entitled to any rate of PIP. He learned that he could ask for a mandatory reconsideration, which he did and was still not entitled; he then went to the next stage and lodged an appeal.
‘Throughout this process the appellant felt a growing sense of injustice and frustration which caused him increasing stress. When he was informed on 24th October 2014 that the appeal would not go ahead, as it had been decided that he did have entitlement, he was greatly relieved. This frame of mind was short lived as he was sent out a new PIP2 (Intervention) in January 2015 and the whole process of assessment (completing new form and attending Face to Face consultation) was started again, culminated in the decision on 7th March 2015 that he had lost his entitlement.
Despite being told in October 2014 that he was awarded PIP from 15th July 2013 till 29th January 2016; his peace of mind lasted only 19 weeks and he had to recommence the Mandatory Reconsideration and Appeal process once again. The appellant feels he has been ‘very let down and disappointed as I feel I may be discriminated against because of my ill health and disability’ (Document 8); he has been made to feel victimised and has become extremely frustrated and stressed by this process.’
Have had clients getting ‘review’ forms around 12 months in to awards of 18mths or more fairly straight forward lists each of the activities with three tick boxes (improved) stayed same (worse) and a comments box asking for further details on improvement/worsening.
Had some just tick boxes for no change and send them back. Not had any decisions back off any of them yet. Not sure if its safe to assume that only those where the entitlement changes will get any further contact - though knowing the ways of IDS probably not safe to assume anything.
[ Edited: 24 Aug 2015 at 04:20 pm by Grunkle ]Section 88(2) WRA 2012 states that a Pip award should be for a fixed term unless it’s inappropriate to set one. And the question of whether it is inappropriate must, we learn from section 88(3), be decided by reference to guidance issued by the Sec of State.
It’s one thing Reg 11 Pip Regs allowing a Pip award (fixed or otherwise) to be re-assessed at any time, it’s another thing altogether for the Dept to have a system/policy for reviewing fixed term awards other than by way of renewal. For instance, where, despite the claimant being given a 2 year award, an automatic review date is set at 12 months based on the recommendation of a Pip medical assessor. Such a policy would appear a clear fetter on the discretion which Reg 11 provides and, therefore, probably ultra vires.
Below is the response we have received from DWP following a query regarding one of our clients who was awarded PIP from Dec 2013 (Award decision in Nov 2014-so 11 month wait for decision!), and received his renewal pack in July 2015.
“Thank you for your email regarding (client’s) claim for Personal Independence Payment (PIP).
(Client) was awarded PIP from 03/12/13 until 27/07/16, his decision letter dated 04/11/14 states that we will contact him again after 27/07/15 to make sure he is still receiving the right amount of benefit.
We issue case review claim packs 12 months before the award is due to expire. Issuing claim packs so far in advance ensures firstly that the claimant or their representatives are given sufficient time to provide the necessary information and secondly, to give the processing unit time to deal with the claim and re-award, if appropriate, without there being a break in the payments.
I hope this clarifies the situation.
Kind regards
Jayne
Jayne Barry
Complaints Resolution Manager
The above raises the following issues:
1) The time limit of four weeks to complete and return the form negates the argument about ensuring the client or rep are given sufficient time to provide information.
2) If the original decision maker makes a fixed-term, e.g. 2 year award, the policy of issuing renewal packs after only half this period implies that the DWP have no faith in their own decisions.
Typical, anodyne, bland and disingenuous DWP double-speak!
We have replied raising the above points, will update on here when (if) we get a response.
This very much reminds me of the argument from back in the day, when our good friends at camp DWP used what at the time was called the Integrity project. Then all DLA claimants were written to inviting them to claim more money from DLA components (yes even High Rate Awards were written too) Back then the argument was just the same. Do the DWP have grounds to disturb an award that has been adjudicated on. As was the norm our arguments proved most successful, however sadly changed the law. even so there still has to be grounds for the disturbance not just a systemic attack on all claimants
Below is the response we have received from DWP ...
We issue case review claim packs 12 months before the award is due to expire. Issuing claim packs so far in advance ensures firstly that the claimant or their representatives are given sufficient time to provide the necessary information and secondly, to give the processing unit time to deal with the claim and re-award, if appropriate, without there being a break in the payments.
Gah! Even DWP are at it now. The 2013 C&P Regs only allow an advance PIP claim to be made up to six months before an existing award is due to end. This is Reg 33(2):
‘A person who has an award of personal independence payment may make a further claim for personal independence during the period of 6 months immediately before the existing award expires.’
The PIP 2 isn’t a renewal claim form, it is more analogous to the random reviews mentioned by Daimo, except for being sent to the majority of PIP claimants a year before the award ends. See my post #7 above.
The reason that I keep banging on about this is that
1) an existing award can be superseded and removed (effective from the date of the supersession decision) if the PIP2 is not returned within a month of the date sent (although you can request an extension of that time); and
2) claimants whose award is NOT reviewed are apparently only reminded to claim PIP again 14 weeks before their award runs out, and this is less than the maximum time a claim involving a face-to-face assessment should take to process. See Billy’s FOI response above. Claimants whose award is not reviewed a year before it ends can claim 6 months before the existing award ends (or request a supersession to extend the existing award even before that). Of course doing either of those things risks a decision that instead reduces or stops the award effective from an earlier date than the end date.
Jon
I hadn’t noticed the earlier page in this thread when I posted above. I’d read a separate thread which talked about reviews ahead of the expiry date of the award. I’ve now read the ADM referred to by Jon and the FOI response and related guidance referred to by Billy at posts 12 & 15.
I cannot see a legal basis for these “planned interventions”. The relevant part of section 88 WRA 2012 provides as follows:
” (2) An award of personal independence payment is to be for a fixed term except where the person making the award considers that a fixed term award would be inappropriate.
(3) In deciding whether a fixed term award would be inappropriate, that person must have regard to guidance issued by the Secretary of State.”
The guidance mentioned in subsection (3) appears to be concerned only with the circumstances in which an indefinite award or what the DWP call an “ongoing award” should be made. Subsection (3) does not, therefore, authorise the “planned intervention” dates which the DWP are setting 12 months’ ahead of the expiry of the fixed term awards.
Whenever a fixed term award is made under subsection (2) it follows that subsection (3) is n/a. So what is the legal basis for this systematic approach to review in the form of “planned intervention”?
As I mentioned in an earlier post the current guidance seems a complete fetter on the discretion to review awards.
Its either a classic fishing trip, or they are expecting backlogs to build up again - more likely the fishing trip. Currently mid MR for one of my clients whose Care dropped from enhanced to Standard because they were reassessed on the dealing with people face to face. No clear (or even obscure) reason for that at all.
A further illustration of this issue.
Client had an initial award of PIP made by a tribunal on 18/12/14 for a fixed period to 26/6/15 (original DWP decision was nil award).
Immedietly sent a PIP2 to complete (returned 1/15) and attended a F2F in April (up to this point appears to be a simple renewal claim as PIP2 (probably) sent within 6 months of award expiry date).
Decision dated 1/5/15 begins ‘I’ve decided to look at your PIP award again to make sure you’re getting the right money’ - which makes it look more like a ‘planned intervention’ rather than renewal decision. It removes the existing award from 1/5/15 (ie before the expiry date of existing award).
Client MRs and appeals 1/5/15 decision.
In the submission to tribunal DWP make no reference to any relevant legislation or the previous claim or (tribunal) decision and provides no copy of any of the evidence that led to the original award. It is presented simply as a new claim.
We requested a judge direct DWP to provide a further submission to address all of the above but judge directed that hearing (next week) goes ahead and (in my terms) ‘let the tribunal sort it out’.
We are inclined to suggest our client ask her MP (David Cameron) to raise her case with the SSWP.
It seems reasonable to assume we can all expect much more of this!
May be one for NAWRA to track?