PIP - Appeal - DWP asking client to go to a medical assessment

We have been helping a client with a PIP Award Review and are now into one of those nightmarish DWP scenarios.

The claimant was in receipt of PIP at the standard rate for Daily Living only. His award ran from 22 June 2016 until 20 October 2018 – his main health issues revolved around his poor mental health.

On 21 October 2017 the DWP started the Award Review process. The claimant underwent an assessment on 15 December 2017 and on 5 January 2018 a decision was made that he was no longer entitled to PIP.

An MRN was sort – the decision was not changed – and then an appeal made.

The appeal was due to be heard on 17 September 2018 (a Monday).

On Friday 14 September 2018 the DWP called the client and told him they would revise the decision with an award of the Standard Rate for Daily Living only – thus restoring the position to what it was before. However, unbeknown to the claimant the award period was only extended to 29 August 2019 and having accepted the decision the appeal did not go ahead.

On receipt of the new decision the DWP letter made it clear that the claimant could appeal directly to the First-tier Tribunal which the claimant has done in respect of the length of the award. The appeal is lodged with HMCTS on 25 October 2018.

However, the DWP have now told the claimant that he will have to undergo another assessment. Is this correct? Can the DWP insist the claimant undergo a further assessment whilst the appeal is pending – this was what the claimant was seeking to avoid by trying to get and extended award period notwithstanding the pitfalls involved.

If I were a betting man I’d put a fiver on the client having made a new claim while the appeal was ticking along.

- However, the DWP have now told the claimant that he will have to undergo another assessment. Is this correct?

Yes. They have the right to request evidence - there is a duty on the claimant to supply.

- Can the DWP insist the claimant undergo a further assessment whilst the appeal is pending

Yes. If the claimant doesn’t attend the claim may be given a negative determination.

-  ...this was what the claimant was seeking to avoid by trying to get and extended award period notwithstanding the pitfalls involved.

Looking at the dates it seems the original decision may be reinstated (with dates) - others will disagree.

The interventions are not renewals.

Where the SSWP fails to explain the reasoning and legislative powers used to supersede an existing award of PIP (22 June 2016 - 20 October 2018) the new decision (ending Aug 19) falls away. Tribunals have been allowing an extra period on the end of a failed supersession - I’m not sure this is legally correct but it is helpful to the claimant.

On the facts presented there is every potential for the original claim to be reinstated and ending 20 October 18.

The requirement for a new assessment may be useful for a potential renewal - there are other options to attending a medical -home visits or paper based assessments may be requested.

If the claimant accepted the revised decision which then provided an award to 29/8/19 it is likely that this also ‘reset’ the date when the ‘planned intervention’ process would next be triggered. As that is usually implemented about 12 months before the end of the existing award the client’s ‘reset’ ‘planned intervention’ date has now been reached and the process has started again.

The client has appealed against the period of the revised award. This means there are two processes running in parallel (a) the appeal (b) the ‘planned intervention’. What happens next will depend on which occurs first (1) a hearing on the appeal (2) a decision on the planned intervention and whether that requires an MR. A positive decision to make an award would, in my view, lapse the appeal because the new award period would likely extend beyond 28/9/19 and the tribunals jurisdiction would be limited up to the date of the new decision - it would almost certainly be considering a closed period of zero days.

Thanks all for your replies - very helpful.

By the way there has definitely been no new claim made.