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PIP question re distribution of points
Hi everyone, my colleague is on annual leave so just wanting to bounce off someone regarding an unusual situation.
My client made a PIP claim back in April and was unsuccessful - just got the decision notice. Her reason for claim was Mental health. However she was awarded a total of 6 points (2 points each) for preparing food, dressing and undressing and washing and bathing - for a physical issue. In June she fell over in the street and damaged her right arm very badly, she is off work, needs physio and possibly an op. I don’t quite know why she was awarded points when she did not claim PIP for this reason, it wasn’t in her PIP form and she doesn’t fit the criteria for application for this issue due to not having had the issue for three months at the time of claim (she didn’t have it at all!) Mind you this rule is not stated on the gov.uk website - only that you expect to have the issue for 12 months or more. (but still on CAB website)
She wants to do an MR obviously but I’m not sure how to broach it because I would say she is at risk of losing the points if brought up. She did argue those descriptors but for mental health. I’m loath to bring this up but if it goes further to appeal and court this will surely be brought up. She is entitled based off her situation NOW as her arm is indeed very bad, but they might look at time frame of accident etc.
Basically me question is : How do I go about an MR when I believe that she should have been scored the points she has been awarded for an entirely different reason when there is a chance she could lose the points because of this? (amongst arguing for other descriptors of course.)
Could I just be over thinking this?!
I hope I’ve explained sufficiently - Thank you for your time and advice in advance.
Could I just be over thinking this?!
I think so.
PIP entitlement depends on meeting the conditions for 3 months and expecting to meet them for the next 9 months (the required period - see reg 12-13 PIP Regs).
However this is all to be judged based on how things were at the date of decision, not the date of claim. Even though your client’s claim did not refer to the accident, it had happened by the time the decision was made so the decision maker needed to consider it.
If the DM had felt that effects of the accident did cause an entitlement to an award, then what they might have done is made an advance award to take effect three months from the date of the accident (Reg 33 Claims and Payments Regs).
I don’t think I would be particularly worried about ‘losing’ any of these points, particularly as there is no award to lose. At appeal, the Tribunal would perhaps need to direct itself that if it were to find that she had a PIP entitlement only due to the effects of the accident, then an advance award would need to be made and that otherwise the entitlement would be from the date of claim.
I echo Elliot on this. Don’t overthink it There is no award to lose and a case can presumably be made for a mix of points based on mental health and the more recent physical issue. Presumably it was thought the client would qualify via MH alone so it’s just a case of presenting the full picture and emphasising what you think the key issue is for each descriptor i.e. what’s the more likely to score or the one which is going to score highest. Get them to 8 on MH alone and the question of start date becomes moot unless the physical issue might then take you to 12.
There will be lots of different viewpoints on this but I tend to the view that once a claim has failed your efforts are better directed to appeal unless there is something very obvious which will quickly turn an MR around. The success rate was circa 53% last time I looked and heading steadily downwards presumably in a reversion to the pre-pandemic norm which at one point was 19%. It’s essentially random, unlike an appeal, which is very much not when it comes to PIP.
Final thing. Appeals don’t go to court. Some venues happen to be part of an arrangement to share court facilities but tribunals do not routinely take place in courts (although it may feel like that for some of us).
I echo Elliot on this. Don’t overthink it There is no award to lose and a case can presumably be made for a mix of points based on mental health and the more recent physical issue. Presumably it was thought the client would qualify via MH alone so it’s just a case of presenting the full picture and emphasising what you think the key issue is for each descriptor i.e. what’s the more likely to score or the one which is going to score highest. Get them to 8 on MH alone and the question of start date becomes moot unless the physical issue might then take you to 12.
There will be lots of different viewpoints on this but I tend to the view that once a claim has failed your efforts are better directed to appeal unless there is something very obvious which will quickly turn an MR around. The success rate was circa 53% last time I looked and heading steadily downwards presumably in a reversion to the pre-pandemic norm which at one point was 19%. It’s essentially random, unlike an appeal, which is very much not when it comes to PIP.
Final thing. Appeals don’t go to court. Some venues happen to be part of an arrangement to share court facilities but tribunals do not routinely take place in courts (although it may feel like that for some of us).
Thank you for this, this sis super helpful. And yes I did mean Tribunal, probably a Freudian slip as it does indeed feel an awful lot like court!
Could I just be over thinking this?!
I think so.
PIP entitlement depends on meeting the conditions for 3 months and expecting to meet them for the next 9 months (the required period - see reg 12-13 PIP Regs).
However this is all to be judged based on how things were at the date of decision, not the date of claim. Even though your client’s claim did not refer to the accident, it had happened by the time the decision was made so the decision maker needed to consider it.
If the DM had felt that effects of the accident did cause an entitlement to an award, then what they might have done is made an advance award to take effect three months from the date of the accident (Reg 33 Claims and Payments Regs).
I don’t think I would be particularly worried about ‘losing’ any of these points, particularly as there is no award to lose. At appeal, the Tribunal would perhaps need to direct itself that if it were to find that she had a PIP entitlement only due to the effects of the accident, then an advance award would need to be made and that otherwise the entitlement would be from the date of claim.
Thank you for this, this is super helpful!