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Forum Home  →  Discussion  →  Disability benefits  →  Thread

change after medical before decision date

LJF
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Benefits caseworker - Manchester Citizens Advice Bureau

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Joined: 12 July 2010

client had lots of health problems but PIP claim refused - appealing.
however she had a stroke after medical but a week before the decision date.
the tribunal looks at how she was on date of decision? so they will take the stroke into account?  but she hadn’t had it for 3 months so can they not take into account or would they look at an advance award/increase for 3 month after the stroke?

obviously she could also make a new claim but that decision would override the appeal outcome?

thanks

unhindered by talent
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Welfare Rights Team, Aberdeenshire Council

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I’d suggest that the stroke doesn’t meet the 3 month condition so can’t be taken into account. If there is a positive appeal outcome, then after 3 months you could ask them to look at the award again if there will be ongoing problems as a result of the stroke. If the appeal is refused, they could make a new claim 3 months after the stroke. Not sure what happens if the appeal isn’t heard in 3 months though.

LJF
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Benefits caseworker - Manchester Citizens Advice Bureau

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Total Posts: 143

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there are permanent sight problems now as a result of the stroke and it has already been 3 months since. thanks

Cordelia
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Welfare rights officer - Wrexham Council Welfare Rights Team

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At the date of decision, the stroke couldn’t be taken into account because of the three month qualifying period.  Any award from that date would be based on her pre-existing health problems / disabilities.

In theory the decision maker could make a decision that the conditions would be satisfied within three months, and set the start date to reflect this.  So if the stroke happened on 1st March, then on 8th March a decision could be made awarding PIP from 1st June. 

I think the main difficulty in arguing that the decision maker should have made an advance award is that the recovery from a stroke can be variable.  Would it have been “likely” that she would still meet the PIP criteria not just in three months, but a further nine months after that?  Who could say?  If there is medical evidence that the stroke wasn’t one that she had any realistic chance of recovering from then it could be worth an argument.

Depending on how long it has been since the stroke / decision I would also be considering making a new claim if the evidence now shows that they are not going to make a full recovery.

unhindered by talent
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Welfare Rights Team, Aberdeenshire Council

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How confident are you about the impact of the original conditions (pre-stroke) meeting the criteria for an award? If not that confident, a new claim might be in order