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Forum Home  →  Discussion  →  Decision making and appeals  →  Thread

PIP refuse to issue claimant a decision on whether they accepted his reasons for failure to attend assessment

SARC
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I wonder whether I can get anyone’s help with this one - my client’s PIP was up for renewal and due to end last month. He completed the PIP2 form back last April ‘18 and was given an ATOS assessment in May/June ‘18. He didn’t attend it as had not received the notification because he’d moved and the letter had gone to his old address. The DWP did not accept his reasons for non attendance, he requested a review and review went in his favour. He then didn’t hear from the department or ATOS for months so he called ATOS who gave him a further assessment date in March ‘19. He tried to attend that one but couldn’t find the assessment centre (not helped by the fact that it was in a different city to his and his phone died so he couldn’t ask anyone for help) so gave up. He called both PIP and ATOS to explain what happened. Nothing until a letter of 14/3/19 from PIP telling him his award had ended.

I called PIP with him this morning and asked them why was he not issued with a decision telling him whether or not they accepted his reasons for non attendance of March ‘19 assessment. She told me that they were under no obligation to do so as his award had ended before that had happened and informed me that there was law to support that they were right in this.

I have made further enquiries about whether this is right with the PIP complaints team (because it doesn’t seem right to me and I have not been able to establish what specific law they are referring to). I have also advised my client to make a new claim for PIP obviously.

Does anyone have any thoughts on this i.e. whether the DWP/PIP is right and if they are right what is the piece of legislation they may be referring to? Much appreciate anyone’s help.

Daphne
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I do not think the person you spoke to is right at all! I think your client ringing to explain his reasons for non-attendance could be seen as a request for a mandatory reconsideration of their decision to terminate the award (though not clear whether it happened before the decision?)

In any event, I would now submit a very clear MR request of the decision to terminate his award giving his good reasons. They absolutely have to give a decision on that, and if they do not change the decision then your client has a right of appeal.

My feeling is that you don’t need the new claim as that will just create a closed period for the decision on this claim.

Elliot Kent
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Was the client paid up to March 2019?

SARC
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Hi thanks for your help .. the answer is yes it seems they issued him with one further payment beyond his award date end to ensure the continuation of his renewal process

Elliot Kent
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SARC - 27 March 2019 07:09 PM

Hi thanks for your help .. the answer is yes it seems they issued him with one further payment beyond his award date end to ensure the continuation of his renewal process

Sorry, but I am going to try and pin you down further because this is really important to figuring this out. What dates were the original fixed term for exactly and was he paid for the entirety of this period?

SARC
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Elliot Kent - 27 March 2019 08:17 PM
SARC - 27 March 2019 07:09 PM

Hi thanks for your help .. the answer is yes it seems they issued him with one further payment beyond his award date end to ensure the continuation of his renewal process

Sorry, but I am going to try and pin you down further because this is really important to figuring this out. What dates were the original fixed term for exactly and was he paid for the entirety of this period?

Sorry I don’t know the start date of his award but the end was 6/2/19 and yes he was paid up to March

Elliot Kent
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Okay, those dates make things a bit weird.

The thing with PIP generally being awarded for a fixed term is that it’s got a set end date. That means that if something doesn’t happen to change that end date before it arrives then the award simply ends with no comeback. Even if that’s not the client’s fault. (Any parallels with our current political situation are pure coincidence).

One way that the award could carry on beyond the end date is if the DWP make a superseding decision - which would generally come about it the context of a “planned review”.

It sounds like your client’s case started out as a planned review until the first FTA - when the DWP superseded and terminated the award. That would have been based on reg 9 of the PIP regs and reg 26(2) of the D&A regs.

Your client asked for that decision to be revised - and it sounds like it clearly was revised because otherwise benefit wouldn’t have been paid beyond that date. But all that would mean is that your client’s original fixed term award through to 06/02/19 was reinstated.

In the course of things, you would then have expected them to arrange a further medical assessment fairly quickly, but they didn’t - they seem to have done nothing until your client phoned up in the dying light of his award.

This is where the dates make things a bit weird. If the second FTA had taken place before the end of the fixed term, then I think that the call centre operator might have been right - if your client’s award had come to its natural end before the FTA decision was made, then your client’s reasons for failing to attend it would be irrelevant. His award would have ended simply because of the ticking clock which was set at the start of the claim. No purpose would be served in making a decision about the FTA if the award has already ended before they got round to making a decision.

But that can’t be what has happened here - because the second FTA took place after his award had already come to an end. Something else must have been going on to justify the medical assessment taking place at all - there can’t be a medical assessment unless there is either a claim or award for it to relate to.

I think that the “something” in question must have been that your client was taken to have made a renewal claim when he got in touch with Atos or whomever near the end of his award. This is more in line with the process which is followed on short term awards where there isn’t enough time to conduct a planned review. Instead they write to the claimant 14 weeks before the end of their award and prompt them to make an advance claim to follow on from the first award.  (see also: http://data.parliament.uk/DepositedPapers/Files/DEP2018-1113/UIN_174062_-_Award_period_guidance_10.10.18.pdf)

So I think that is where you are left. Your client has had two claims for PIP - the first one ended (correctly) due to the passage of time but they have (incorrectly) failed to decide the second one and still need to do so by reference to whether he had good reasons to not attend the 2nd medical (and if so, what points he ought to have scored etc).

Perhaps that is just a load of stream of consciousness style twoddle which essentially leaves you in the same place as Daphne has already explained, but I have written it out already and may as well post it.

ClairemHodgson
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this may be relevant /of assistance

https://www.bailii.org/uk/cases/UKUT/AAC/2019/103.pdf