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PIP reviews and backdating
Hi i have a tenant who was receiving standard rate mobility pip. She had a review form which we completed and returned in July 2021. her health had deteriorated and i feel she should have been awarded standard rate daily living also. she has still not had another assessment, she has complained several times and also gone through her MP. PIP just keep replying stating her original award has been extended. its not just the issue of her losing out on the PIP award she has 2 non dependants at her house, if she was on PIP daily living there would be no housing costs deductions made from her UC award. this is now complicated by the fact she turns pension age in December. my question are 1. when she is finally reassessed will any new award be backdated to the date of the return of the review form and 2. if this happens after her UC claim is closed down how will we get the housing costs deductions backdated on the closed claim.
From what you are saying there was a decision made that she should only be awarded mobility following renewal in July 2021.
You also say “i feel like she should get daily living”
If this is the case, then the decision should have been appealed at the time, however if decision made over 13 months ago then you cant appeal this. What is the date of decision???
I recommend you call PIP and demand a review form and go thru process again if over 13 months.
I think the July 2021 thing may be dead in the water, and unless it was appealed there will be no backdate
The pension thing isn’t a issue, she can stay on PIP at pension age.
Hope that helps
Hi thanks for the reply. i think she would only have been entitled to the PIP daily living at the time we completed the review form not before. she has just called me and she finally has her assessment next week. there is no need at present for an appeal as i feel her original pip award was correct and am just hoping that at her assessment her award will be increased i just want to know if she does get an increased award will this be backdated to the time her review form went in ? i am aware that she will stay on PIP as a pensioner i just want to know if the pip award is increased and her UC stops how am i going to get the housing costs deduction removed back to the date her pip is increased if she is no longer on UC. hopes this clarifies things
.. i just want to know if she does get an increased award will this be backdated to the time her review form went in ?
If the review was initiated because she reported a change then any increase should be backdated to the date she reported the change. If the review was initiated by DWP as a normal review then the change would only apply from the decision date.
If she worded her complaints as ‘My health is worse and I should get a higher rate from now’ I’d argue these were requests for supersession and increases in award should at least run from the date of the first such complaint.
If it was just complaints that the review is taking too long then that might not fly.
Whether changes reported in the DWP initiated review forms can amount has been raised a number of times, and I think the general conclusion was that, as Ian said, the change only applies from the eventual decision date.
Posting here in case anyone can point me in the right direction before I go reading the legislation/caselaw.
I have a similar case where a PIP claimant requested a supersession in July 2021. They still hadn’t been assessed a year later, and a medical assessment was finally completed following JR threat in July 2022. The backdated payment only goes as far as the medical assessment date.
Should it go back to when the change of circumstances was first reported? If yes, which rules and cases should we be relying on?
I’ll dig around myself when time allows and post my findings here - if someone else doesn’t beat me to it!
The effective date of supersession depends on which grounds were used.
Two grounds are relevant - regs 23 and 26 D&A.
Reg 26 applies where medical evidence is received - i.e. the HCP’s report. The effective date is the decision date. The DWP will usually rely on this ground.
Reg 23 is used for changes of cirumstance. The effective date is typically either the date the change occurred or was notified (see sch 1 D&A).
You can appeal the decision on the basis that reg 23 is the appropriate ground of supersession and that the effective date should be earlier.
You would stand the best chance if you can show demonstrable change in the client’s health which was clearly reported at some earlier point rather than it being, say, 2 HCPs taking different views on similar facts.
[ Edited: 19 Oct 2022 at 09:51 am by Elliot Kent ]Found the relevant passage in CPAG handbook:
If you apply for the supersession, it usually takes effect from:
...for PIP, the date the change takes place, or is expected to take place. You must notify the DWP of the change within one month of the change. However, if the change means you are now entitled to a higher rate of benefit, the supersession takes effect from the day you satisfy the conditions of entitlement for that rate.
https://askcpag.org.uk/?id=-236676
And the relevant regulations: https://www.legislation.gov.uk/uksi/2013/381/schedule/1
We will ask the DWP to backdate entitlement to the date that a change of circumstances was notified, and see what they say.
Can the DWP decide that the conditions for a higher rate were met on a date before it has completed the medical assessment i.e. when the claimant reported a change in circumstances?
Thanks Elliot - our replies crossed over. That answers my Q perfectly!
Can the DWP decide that the conditions for a higher rate were met on a date before it has completed the medical assessment i.e. when the claimant reported a change in circumstances?
Yes, that is what reg. 23 is for - and if the DWP doesn’t decide that, a tribunal has the power to do so.
The DWP often gets the law wrong or doesn’t have a complete understanding of it - which is part of the reason it will more often use reg. 26.
I think some of what has been said earlier is slightly off. In terms of the effective date for supersession of an existing award, if the change was declared via the claimant requesting a supersession (I’ve got worse, please send me a new form and look at my award again) then yes, the effective date is the date the claimant requested supersession. But there seems to have been a suggestion that if it’s via a planned review or renewal initiated by the DWP (which will be sent out some time before the end of any current award) then reg. 26 applies - i.e. the effective date is the date on which the DWP receives the HCP report. But that’s wrong, I think - if the form returned by the claimant contains clear statements which, if accepted, mean that they now meet the conditions for an increased award, then they have disclosed a change of circumstances - and disclosure is effective from the date the form was returned.