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Thread: Case manager

  1. #21
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    Quote Originally Posted by KAREN SV View Post
    Toolook, would it ever be possible that a decision is made without the assessment report and only on the actual form filled in by you when making the claim? (IF say the claimant has their MP fighting for them and they are stressed at the length of time its taken?).
    I don't know, however I will say that an MP cannot force the DWP to do anything as it would be an abuse of process. The DWP still has to justify a decision and having an MP on your side does not change that, if say there is plenty of medical evidence and it is clear what level of award should be made then an MP MIGHT be able to persuade the DWP to look at it without a F2F. However, if the claim form had no medical evidence and was based on the word of the claimant then I would say that is very unlikely, if not impossible as the point of PIP was to have regular Face to Face assessments with the claimant. Even on DLA, 5% to 10% of claims had positive decisions, based on there claim with no medical evidence just the claim form ( I can't remember the exact figure but I think it was in that area).

  2. #22
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    Quote Originally Posted by KAREN SV View Post
    Toolook, would it ever be possible that a decision is made without the assessment report and only on the actual form filled in by you when making the claim? (IF say the claimant has their MP fighting for them and they are stressed at the length of time its taken?).
    The PIP system works on the basis that the decision maker cannot assess the evidence by themselves, but must consult the assessment provider for the area where the claimant lives to obtain a report based on the evidence.


    It is possible for the assessment provider to report solely on the written evidence without a face to face assessment, but this is only done in cases where a face to face assessment is felt to be unnecessary. Most of these cases will be where the claimant has submitted a DS1500 report from a health professional confirming that death is reasonably expected within six months, which, if accepted, results in an automatic award of enhanced rate Daily Living PIP.

    Other cases of 'papers only' assessment are rare - an example would be someone who had sent in a comprehensive and recent functional assessment prepared by an occupational therapist along with their claim, though few will be able to do that.

    If there is any doubt as to how the claimant's problems affect their abilities under the activities, there will be a face to face assessment.


    There is no way you can get a decision made without an assessment report based on matters, such as delay, how many times you have complained to your MP or how stressed you are by the process. Such a system would breach the principle of equality before the law, that everyone is assessed equally according to the criteria. It would also be wide open to abuse.

    I'm not saying anything here about how your admittedly deeply unsatisfactory experience has affected you, Karen - I'm just saying that if it got around that it was possible for claimants to bully the system into awarding PIP without proper medical consideration of the evidence they'd submitted, this would create an unfair system where those who shout loudest (which will include those knowingly making false or exaggerated claims) get PIP without proper reflection on whether they meet the criteria.

  3. #23
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    Quote Originally Posted by KAREN SV View Post
    I also added another paragraph to my post above whereby the case manager should actually explain what is wrong in the assessment report and why she disagrees with the assessor on so much so I can get my sore head around her reasoning and look into the law myself or with an advocate.

    I would like this with mine if she now turns me down at reconsideration. I know my report was sent back to Capita again for re categorisation (I assume this means adding points and taking them away AGAIN) so I feel that maybe I should also be allowed to take action about being assessed by an assessor that the DWP are saying is not trained enough to assess. Its a minefield and disgusting how they are treating ill people. (Now I am moaning lol). I put my LOL through gritted teeth. My head is in tatters.
    You can't create legal rights that don't exist. There is no right to a 'blow by blow' explanation of why the Case Manager has departed from the assessment report.

    If you disagree with the Case Manager's decision, you put your reasons forward for an alternative decision, and a Case Manager reconsiders the decision.

    If you disagree with the reconsidered decision, both you and the DWP can put arguments before the First-tier Tribunal, which makes a fresh decision by applying the law to the facts found proved.


    In other words, it's the reconsideration and appeal processes that provide redress if you believe the wrong decision was reached. In every case, you get PIP by showing it is more likely than not that you meet the criteria for PIP, not by showing that the assessor and/or Case Manager was wrong to deny you PIP.


    Unfortunately, nobody else here has sight of your assessment report and the initial decision letter, so we cannot explain why the Case Manager settled on different descriptors to the assessor. What we can say is that the assessor makes a recommendation for the appropriate descriptor in each activity, but it is just a recommendation and no more.

    The problem is likely to be that the evidence recorded by the assessor only supported the award of a lower scoring descriptor for some of the activities. The assessor's primary job is to assess and report on those factors that are relevant to PIP - the recommended descriptors are an ancillary function.

  4. #24
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    Any process which involves humans is subject to error. And any process which involves human interpretation of a description is subject to differences of interpretation. To remove this room for differences in human interpretation ATOS invented a system for ESA which in the main used computer logic to try to remove the Assessor's impact on the decision and look how that turned out.

    Because there is always room for error or different interpretation of facts , this process has not just a mandatory reconsideration process but an appeal process. It is hoped that in the end a correct decision will eventually be reached. Even then there is still the possibility a person won't be happy with the outcome or agree with it.

  5. #25
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    Thank you everyone for their input. I hope this thread is of use to the original poster and has shown claimants some views on how this process works. I am none the wiser until my reconsideration is completed and that hopefully should be in the next week as told by the manager from the disputes team who called me some weeks ago. I wish myself luck and just hope there was some human error or at least that if not, I have explained my problems better in my letter to them and I eventually get an award.

  6. #26
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    Quote Originally Posted by seriouslyfedup View Post
    Any process which involves humans is subject to error. And any process which involves human interpretation of a description is subject to differences of interpretation. To remove this room for differences in human interpretation ATOS invented a system for ESA which in the main used computer logic to try to remove the Assessor's impact on the decision and look how that turned out.

    Because there is always room for error or different interpretation of facts , this process has not just a mandatory reconsideration process but an appeal process. It is hoped that in the end a correct decision will eventually be reached. Even then there is still the possibility a person won't be happy with the outcome or agree with it.
    Best post on this thread.

  7. #27
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    I join you in hoping that you succeed at reconsideration, Karen. As you say, the outcome is unknown until the notification comes through, which hopefully will be soon.

    In the event that you do not succeed, I'll provide whatever input I can towards an appeal, whilst hoping that you can get some support from an advice provider. Refusal at reconsideration is not the last word. The only forum member I recall starting a PIP appeal never got as far as tribunal. DWP reconsidered again and awarded him PIP without a tribunal.

  8. #28
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    hikaren did the case manager ring you with the decision originally thanks

  9. #29
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    If PIP is being awarded, the Case Manager usually does not ring.

    If PIP is not being awarded, the Case Manager usually phones to discuss the reasons for rejecting the claim once the claimant has received a notification letter.


    The Case Manager has the option of phoning the claimant to discuss the claim before making their decision if there is something they want to clarify, though my impression, based on posts in the forum, is that this rarely happens before an initial decision.


    burkey007 - nobody can tell you for certain what will happen with your claim. Hopefully, from the questions you have asked, you are now clearer what is likely to happen and when.

    Hard as it is, the best advice I can give is to try to wait for a decision letter to arrive. I know we all want answers, but there's really nothing you can do to receive a quicker decision. Once you have your decision letter, hopefully we will be able to help you understand anything that doesn't make sense.

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