PIP no f2f assessment and paper based review.

[alisonra]

Has anyone applied for PIP and had paper based review or decision without attending the face to face assessment?

I am not terminally ill or come under special rules. I applied for personal independence payment in Nov 2013. In last 6 months I made several telephones calls to DWP and ATOS to chase my application and every time I was told to wait until I get the appointment for face to face assessment. Couple of weeks ago I contacted my MP and asked for his help in this matter. He very kindly wrote to the ATOS Healthcare who told him that they have already considered my case and I won't be called for face to face assessment. They also told my MP that the claim is now with DWP decision manager. Upon contacting DWP I was told to wait another 8 weeks for final decision.

I have over 3 inches leg length discrepancy, osteoarthritis, diabetes and high blood pressure and walk with special boots with extreme difficulty. Along with my PIP application I sent couple of letters from my consultants and my repeat prescription which shows that I'm on 8 different types of life long medication.
To be honest I was hoping to see the ATOS so they can actually look at my condition but now I am very concerned as why have they made a decision without seeing me and I fear that I'm likely to be refused.

[Flymo]

There is an ongoing push to bring PIP down from the 97%+ of claims resulting in face to face assessment in the early months to something closer to the 75% of claims resulting in face to face assessment that DWP had planned on. I've written more about this in the thread on the new edition of the PIP Assessment Guide.

All PIP claims start out with a paper based review. Many of the claims that will not proceed to face to face assessment following that review will be those that showed essentially no prospect of entitlement to PIP. Yours falls at the other end of the scale - the medical evidence supports your claim of severely limited walking ability that is likely to be lifelong.


I wouldn't want to "count chickens" too much, but I don't believe there is much doubt over the outcome in relation to the Mobility component on the facts you give.

You don't mention anything relating to the Daily Living component. If you made no submission over Daily Living, or gave a clear explanation of the difficulties you face with the Daily Living activities that is supported by the medical evidence, I can see why your case has proceeded on the grounds of a paper based review only.


If you read about my claim, there's a reasonable argument that the face to face assessment didn't add much and that an assessment report based solely on paper based review would have come to the same outcome. It is possible I would have lost a few Daily Living points, but I had 11 to spare so could have dropped all the way from 23 to 12 and would still have got enhanced rate Daily Living.

If there was doubt about the correct Daily Living descriptors in your case at paper based review, and this doubt might change the outcome, I would expect you would have been called for face to face assessment.


Ultimately, you will have the same reconsideration and appeal rights as anyone whose assessment report was based on a face to face assessment. If relevant things were missed out of the assessment report, you can challenge the outcome at reconsideration.

As this recent thread shows, it's possible to go from 0 points at initial decision (in this case following face to face assessment) to enhanced rate of both components (with points to spare for each) following reconsideration by clearly explaining the case for awarding PIP backed by medical evidence. This shows the power of good quality written submissions backed by medical evidence, which should work just as well at initial decision following paper-based review only as at reconsideration.


Try not to despair about the prospects of success. I can't see that your claim falls into the "low functional effects, no hope of PIP" bracket, which suggests it is being seen at the other end of the scale.

[alisonra]

Thank you million times Flymo for such a good and detailed advice. I feel lot better now.

Yes I did complete the daily care section and gave info about my care needs as well. I suffer from severe anxiety, severe mood swings and panic attacks as well and I am on currently on Prozac 20mg x 3 a day. My husband is my main carer but he is also full time self-employed. I am fully dependent on him as I need physical and moral support from him most times of the day.

This is the first time in my life I've applied for any benefit, I have been suffering from all the health problems for the last 20 years and worked throughout this time. I always thought due to my full time cleaning job I cannot clain disability and carried on coping with pain by taking the prescribed sedative painkillers until now last year when my condition got worse.

My form was filled by the local citizens advice and he advisor was very experienced and helpful. Along with my application form I sent a letter from my podiatrist in which he mentioned that I have 8 cm leg length inequality with severe valugus deformity (means my right knee is permanently dislocated and deformed) and I need to be reviewed by the local orthotic department. In March I sent PIP another letter from an Orthopaedic consultant and my updated prescription for their and ATOS consideration.

When I was made aware, through my MP, that ATOS is not going to call me for f2f and they have already done the paper based review as they had 'enough' evidence to do the final report. I was under the impression that ATOS most had contacted my doctors and/or looked in to further evidence I sent in March. For peace of my I contacted all my doctors and none of them received anything from the ATOS. I was under the impression that I rang ATOS and asked how they have done the paper based assessment without consulting any of my doctors. I started panicking and rang ATOS who told that they used the information given in the application form (PIP2) and the podiatrist letter to do the paper assessment. They also confirmed that they never received any further evidence via PIP office and it's too late now as the report has already gone to the PIP decision maker.

I then contacted PIP office and spoke with a very helpful lady, she confirmed that they further evidence was received in March and was passed on to the ATOS, but she also confirmed that the final assessment report is with the decision maker who will take 3-8 weeks to make the final decision. Upon asking the lady said that I can send the same further info again along with the photographs of my legs which I want to send so the decision maker can see how short and deformed my right leg is.

Last week I sent all the above further evidence, along with a covering letter, and photographs of my legs, my standing posture as I only stand on one leg and photos of bruises which I get on my legs due to frequent cramps and spasms.

To be honest I am not holding my breath as I am expecting anything from the PIP and ATOS. I will be surprised if ATOS deemed me as disabled without consulting my doctors and/or f2f assessment. And yes Flymo, if I am turned down then I am defo appealing the decision.

Many thanks again. Alison x

[Flymo]

Please consider applying for ESA as well as PIP, Alison. You've worked full time for 20 years until you reached the point of being unable tor work. I see no reason why you should not claim the Contributions Based ESA your NI contributions should entitle you to. If you delay too long over any ESA claim, it will be too long since you last worked, so you will no longer meet the contribution conditions.

You will need a 'fit note' from your doctor confirming you are unfit for all work to be put on the ESA assessment rate.


Do update us when you get your PIP decision. If you're not happy with the outcome, I'm sure people will do their best to advise you.

[irishkitty]

Hi my son has autism with moderate/severe learning disabilities, he is 16 years old and was receiving dla middle care, low mobilitly, I applied on his behalf for pip on 3 feb 2014, I returned the completed pip form 3 march along with as much supporting evidence as I could gather including a letter from school, his OT and his moving on plan for college. I didnt hear anything for quite a few weeks so decided to ring Atos after a few months, I was told they were waiting for more info from people they had contacted, his OT was contacted by phone from the assessor and had a conversation for over an hour about my sons disabled adaptions (wet room, bidet and locks to keep him safe), it was then decided he wouldn't have to go for a face to face assessment as they had enough evidence to do a paper one, Atos completed his assessment on 29 may and dwp decision maker made their decision 11 june, he was awarded enhanced care and enhanced mobility, he can walk unaided but needs someone to keep him safe, his award is until 2024, I am completely over the moon and relieved he didn't have to have a face to face, I answered every question on the pip form in as much detail as possible, I included 15 extra pages of how my sons disability affected him in relation to each question it was very tedious but no worse than the dla form, it seems if they have enough info they can do an assessment with a face to face.

[Flymo]

Well done, irishkitty. I think there were three things that helped your son avoid face to face assessment - the detailed information you supplied, his autism and the involvement of an occupational therapist who could give information about your son's needs.

If the assessment provider has a clear picture from the written submission and a professional experienced in functional assessment to ask any follow-up questions to, there seems no point calling someone for face to face assessment, especially when the claimant has autism.


It's important to send in the best written submission you can. A poor quality written submission risks giving the assessment provider insufficient evidence to compete assessment on paper based review only, also you risk losing points unnecessarily.

[alisonra]

Dear all and Dear Flymo

Just came off the phone. DWP case manager rang me and told that I have been awarded enhansed rate of daily living and standard mobility. He told me that I have scored 21 for daily living but only 10 points as I ticked on the box that I can walk 20-30 meters with the help of a crutch. I asked if they could reconsider the mobility but the DM said NO. He told me that I should receive the award letter and money in next 7 -1 working days. I forgot to ask him how long this award is for.
Not sure if I should be asking for MR or leave it as it is but THANKS Goodness this painful journey is over, well hopefully.
Many thanks to this forum and Flymo you are the BEST.
Bless xx

[Flymo]

Congratulations on the award - enhanced rate Daily Living and standard Mobility is a good result, and there should be well over a thousand pounds of back money heading your way.


If you wrote on your claim that you can walk 20-30m, I think it will be quite tricky to argue at this point that your walking ability safely, repeatedly, to an acceptable standard and in no more than twice the maximum time taken by a well person is actually less than 20m. That said, if you can walk 20-30m on some occasions, but only once or twice a day and only at a slow speed once you pass 20m, it may be that you should fall into the 1-20m descriptor for "moving around".

If you feel your mobility should be looked at again, you do have the option of reconsideration, where you would have to paint a very clear picture of your walking abilities and explain the 20-30m comment. Is 20-30m with a crutch the most you can manage when you really push yourself?

If you don't challenge the "moving around" descriptor now, you can always report a change of circumstances in the future or paint a clearer picture at renewal.


The decision letter should help you decide what to do, especially the length of award. Even if you're disappointed at standard mobility, you should still have the right to a Blue Badge without further assessment and you will have the right to half price Vehicle Excise Duty on one car.


Are you going to apply for ESA?