PIP - no medical assessment but 6 points for Daily Living

My client is appealing his PIP refusal. He got 6 points for DL, but he wasn’t invited to a medical assessment and the decision was only made using his PIP2. I suspect the Tribunal will be adjourned for an assessment, but I wondered if there should be an explanation/justification of why one wasn’t carried out in the appeal papers?

Thanks

There is usually a Review filenote PA1 form in the papers which is completed by someone at Atos/Capita and advises whether a consultation needs to go ahead or whether the case can be decided from the papers. Don’t expect it to go into much detail as to its recommendations though.

Is it definitely just the PIP2 or has Atos got some info from elsewhere too (a LCW assessment or a GP form, for example)?

When PIP was first launched the DWP stated that around 25% of claims would be decided without the need for a face to face consultation. I don’t know what the actual figures are 2 and a bit years in but I have seen a few go through just on the papers. As the numbers of claimants rise and waiting times go back up I’d imagine the number of claims decided without a consultation may rise in future.

When you say you expect the hearing to be adjourned for an assessment, are you arguing for this? I would not expect that it would happen as a matter of routine and it may not be the best way forward. Further medical evidence may be more helpful for your client if it’s available. That way the loaded consultation process cannot be used against your client, i.e. he got here and therefore can walk more than 50m, or he spoke coherently to the nurse therefore he can’t possibly have mental health problems, etc.

seand - 20 July 2015 11:17 AM

I suspect the Tribunal will be adjourned for an assessment, but I wondered if there should be an explanation/justification of why one wasn’t carried out in the appeal papers?

Thanks

I’d agree with Billy that this wont be routine.

I had one where even the DWP accepted the F2F assessment was poor. The first tribunal queried whether another report could be done to which the PO said it was not part of their contract (with ATOS) to be able to to do this. Tribunals I dont think can order one. The DWP indicated they could ask ATOS but would likely face a cost implication for doing so.

In the end it was adjourned for other medical evidence, not another assessment

Do tribunals not send people for HMCTS assessments any more? Or did I dream this?

Thanks for the replies. I’ve done very few PIP appeals so far, but a colleague has had a tribunal adjourned for a medical assessment to be carried out so I assumed it was a fairly common occurrence…. I’m aware that an assessment might not be that helpful, just that it may happen.

There’s nothing in the papers to explain why they didn’t seek any further information, even from his GP. His GP is a surgery that won’t write letters, but he’s got recent letters/reports from his medical file which say nothing conclusive either way…

I have had a few of these appeals coming to us where no face to face assessment has been done but claim turned down. Some have a PA3 scrutiny assessment in them which looks very like the full assessment report but is based on the part 2 and whatever else was sent with it. The one I am working on today is a client with severe mental health problems with suicide risk with extensive MH team evidence and care plan in the papers yet only 5 points for DL and nil mobility. I despair but I am really ‘enjoying’ getting my teeth into it.

I’ve seen a couple of similar where they have relied on the point score on the PIP2.