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Thread: Mandatory Reconsideration Letter - Help please

  1. #1

    Mandatory Reconsideration Letter - Help please

    Hi everyone

    I was hoping I wouldn't have to write this letter, but unfortunately, my dad's PIP award letter came yesterday and it wasn't quite what we were expecting (8 points for daily and 4 points for mobility - although dad is wheelchair bound and is not allowed to go out on his own due to his medical conditions).

    Pretty shocking result in truth and there are a number of categories which have been badly judged. I have written a letter to send to the DWP but I would love to get feedback before I send it.

    Also - is it advisable for me to collect additional medical proof as I suspect the DWP didn't take anything I sent previously into account.

    I am sharing the letter I have written below - it is rather long (sorry) and would appreciate any feedback and advice.

    Thank you

    *******PART 1, Part 2 is in the first reply to this post********

    I am writing to ask you to reconsider your decision dated 19th September 2016 about my Personal Independence Payment claim.

    I have multiple complex medical conditions which require constant monitoring. I am a stroke victim which has impacted my mobility, my mental capabilities and my general demeanor. I also have a mechanical aortic valve which is controlled by medication. And I have recently been diagnosed with cataracts.

    I am unable to lead a normal life due to my disabilities both physically and mentally. The main symptons that I experience are unable to undertake everyday activities unaided (meaning I need another person to assist and help me). These include washing, dressing, eating (including taking medication), exercising and moving from one location to another. Due to my mental incapabilities, all my financial planning is conducted by my family (wife and son).

    I have problems with communication and I have been known to shout at my family and carers and at other times feel timid when there are people who I do not recognise.

    I have left side neglect which has been medically diagnosed by the RNRU Neurologist Unit. This states that I am unaware of what is happening to my left hand side and means that I am at risk of either injuring myself or a third party.

    I also have weakness in my legs and arms meaning that I am unable to stand for a prolonged period of time and lift my arms as high as a normal person. However, there are rare days when I have had good rest where I my symptoms seem better than what they normally are.

    I believe the decision did not properly take into account how my disability affects me.


    Preparing Food
    I am easily distracted and often forget what I am doing. As I am a wheelchair user, I am unable to stand to cook or prepare my food and if I do stand, I must hold onto something to ensure I am balanced, thus making this task difficult. I also have problems with my left hand where I am unable to fully open my fingers and they often close and remain closed. I struggle to hold items easily and I sometimes shake and have injured myself with a knife and burnt myself with hot water.

    I was originally awarded 2 points for this as it was felt I could prepare of cook a simple meal with an aid or appliance. I believe I should have been awarded 4 points - I need supervision or assistance to either prepare or cook a simple meal

    Eating and drinking
    I need reminding and encouragement to eat. Without it I forget to eat or just don’t bother. I don’t have much of an appetite and often argue with my family. When I am feeling very down I feel like I don’t deserve food – I have been prescribed anti-depressants (Citalopram) to help combat this. Due to my hand issues (shaking and the closed hand) I have to ask my family to cut up my food so I can eat it and often, I need assistance from my wife to help eat.

    I was originally awarded 0 points but I feel this is closer to 4 points as I often require encouragement to eat and it is only due to the care and support I receive from my family that I do eat.

    Managing my treatments
    My GP and Pharmacist provide me with a dosset box for my medication. However, due to my mental disability, I forget to take my medicines. My wife and children ensure I take my medicines every day. I have had episodes where I have refused to take any medicines as I feel they are not necessary and I do not appreciate the importance they have on my daily life.

    I have been given a set of exercises from an Occupational and Physiotherapist to ensure I stay strong. I must do approx. 5 hours of these exercises a week but it usually takes much longer and requires the assistance of my family.

    In total, the time to administer my medication and to support me in my therapy, my wife and children must spend between 12 and 15 hours a week to assist me. This is broken down into 1 hour/day to administer my medication (7 hours/week) and between 5-8 hours a week to assist me with my therapy and cajoling me to complete it.

    It is clear that I am unable to manage my own medication and treatments. My family support me everyday to ensure I take all my medicines and complete my exercises. I believe I should have received a conservative score of 6 according to the descriptor.

    Washing and bathing
    I have a carer who comes everyday to help me get washed and dressed. They hold me while I sit in my bed and then transfer to a shower chair. This is then wheeled into the specially adapted wetroom so they can shower and wash me. The carer will wash me as I tend to only rub the same area of my body (my stomach or arms) and forget that I should wash every part. My carer then dries me and dresses me. I usually wear loose clothes so that they are easy to put on and take off. I often lose concentration when I am washing/dressing and I have been known to ask why my carer is washing or dressing me.

    According to the descriptor, I require assistance to get in or out of a shower. While the shower trolley is considered an aid, the assistance is to get in and out of that chair which is important for my showering needs. Further, it is my carer who washes the majority of my body as I am unable to do so. I believe I should have been awarded 4 points.

    **************

  2. #2
    Did you send a copy of his care plan, that the carers sign when they come each day? That is the best evidence you can use. Im currently doing an MR myself which is along these lines, mine is 2 A4 pages. Good luck. I dont know if dwp will read it all but if it goes to tribunal it will be.

  3. #3
    Hi Oimum - original claim included my dad's care plan (amazing how it got disregarded).

    That is only the first half of the letter... this is the 2nd half...

    Dressing and undressing
    Due to my mental difficulties, I cannot choose appropriate clothes for the day. For example, I have asked to wear pyjamas when we are going to a wedding. I often ask to wear heavy jumpers when it is extremely hot outside. My family have to pick out my clothing to ensure it is appropriate for the situation.

    Further, with my closed grip, I find it difficult to close buttons on my shirts and I can strain myself when taking off/putting on t-shirts/jumpers (as I cannot fully extend my arms).

    I was originally awarded 2 points for this and I am not sure if this should have been 4 points due to the fluctuation of my disability.

    Communicating
    While I appear to understand everything that is being said to me but when I am asked if I understand, I will simply nod yes but when questioned, I will be confused. I tend to hide my confusion by appearing to understand as I feel embarrassed when I do not understand and have to ask questions.

    I will turn to my family for support after the event and ask them to explain what happened and for further explanation. I sometimes tend to veer off track with my discussions with people and will start talking about different things.

    On a good day, when I am well rested, I am able to have a good conversation with people. But when I become tired, I will struggle and forget important elements of my life or the day. I tend to keep my answers vague so that it seems I have answered the question, but when I am asked for details, I will struggle.

    While it seems I am able to communicate easily, the mental disabilities that I have mean that it is much more difficult and daunting. According to the descriptors, I would suggest I need communication support in the form of an additional person to help me understand what is being said and the context (4 points).

    Reading
    I can read items and stories with the aid of my glasses. The difficulty I face is when I have to ask for meaning on what I am reading. So while I can read words off a page, I struggle to understand complex sentances.

    I am often looking at the daily newspaper and I would spend a good part of that morning reading articles, but asking my wife what they meant and what the article was about. I cannot understand the difference between an article and an advert – I believe everything is the same.

    The descriptor for reading suggest that I can read and that is correct. However what I read doesn’t make sense and I need support and assistance everyday for this. I believe I should be awarded a score of 2 points for this. I was originally awarded 0.

    Mixing with other people
    I need help from trusted friends and family when I am in the presence of strangers. I am happiest when I can see someone who I trust nearby and will engage with a stranger. However, if I am on my own and not feeling very well, I will stay quiet and withdrawn. I feel happier when there is someone who I know in the nearby vicinity. Although, I often lose focus and will start slouching and leaning on my hand. I get upset that I cannot talk about the things others can do and this makes me angry. When I get angry, I will tend to shout at the people I am engaging with and have sometimes thrown the nearest object in my frustration.

    As an example, when we were originally applying for a PIP, during the phone conversation with I got extremely angry and irritated and threw the phone at my son as I wasn’t able to understand why they kept asking me lots of questions.

    I was originally awarded 0 points as it was felt that I could engage with people unaided. I believe this is incorrect as I need support to engage with people. I believe I should have been awarded 4 points.

    Making Budgeting Decisions
    I cannot make any budgeting decisions at all. I get confused by monetary amounts. I am trusting of people who I need to pay and can get taken advantage of. I get anxious with bills as I don't know how to deal with them especially now that I am disabled. My family have taken control of my financial matters. My son pays for the household bills and has taken financial control of the house mortgage as I am unable to keep on track.

    I was originally awarded 0 points for this and I believe that is totally incorrect. I handle small amounts of money and I trust the people who I am paying to only take the correct amount. I have examples of when people have taken more money than they should and my family have had to request that money back.

    I believe I should have been awarded 4 or 6 points. I am able to offer money to people who need paying, but I cannot work out how much I should give. So I understand payment is due, but am unable to work out what I should be paying them. Anything more complex like household bills are handled by my family.

    Planning and following a journey
    I cannot follow the route of an unfamiliar journey without another person. I need to have someone with me when I'm outside at all times. I become withdrawn and lost and am unable to ask for help. I also suffer from left side neglect and it is dangerous for me to make any journey on my own. My GP has recently rejected a request for a motorised wheelchair due to the inherent dangers.

    I cannot take any journey unaided. Even if I was to plan a route to the toilet in a restaurant, I would need my family to help me as I would bump into people and tables due to my left side neglect.

    Longer journeys to unfamiliar locations are not possible as I would get tired and disorientated. I cannot go unaided due to the dangers of being left unaided.

    According to the descriptors, I should be awarded 10 points as I cannot follow the route of an unfamiliar journey without another person. It is simply too dangerous for me to be on my own. I was originally awarded 0 points.

    Moving around
    I am unable to walk any distance unaided. Unaided meaning the help and support of another person. On very rare good days, when I feel happy and well, it is possible for me to walk with a frame (an aid) for a maximum of 30-40m. However, I must be accompanied by another adult who can look after me once I become tired and when this happens, I lose the feeling in my legs and I have fallen onto the floor and injured myself. I also have left side neglect, so I have to be accompanied by an adult at all times to ensure I do not injure myself or a third party.

    While I was originally awarded 4 points, I believe the options of moving between 20 and 50 metres with an aid is better representation of my disability.

    In Summary
    I believe a number of errors have been made in the original assessment and scoring of my capabilities and I believe I have outlined the reasons why in this letter.


    Thank you for reconsidering the decision.
    Yours sincerely

  4. #4
    Senior Member
    Join Date
    Apr 2014
    Location
    England
    Posts
    385
    Hello somenextperson

    I'm no expert regarding what the DWP need in order to award PIP but I did notice throughout your MR letter there is no referencing to your medical evidence. Does any of your medical evidence talk about your dad's walking abilities, or lack of, if so - point it out by saying for example as DR Smith GP of 20 years says Mr X is unable to stand unaided and can only walk two steps etc etc.

    If you have more examples of things you can quote from medical evidence that match the descriptors like washing, eating etc quote them too. By doing this you are reminding them that other medically trained people know both your illness and the effects it has on you.

    Hope this is of some help.

  5. #5
    Good point Buble.

    I have asked for an update from my dad's GP, Social worker, Physio and Neuro consultant. Once I get everything back, I will be updating accordingly.

    Thanks

  6. #6
    Just an update on this. I have now received the Medical Report from the DWP. It makes lots of references that my dad is able to complete most tasks.

    Interestingly - because my father isn't receiving any help with his memory issues, "it is reasonable to suggest he is able" to complete most of his tasks. The reason for no memory help is because it is a situation that cannot be rectified.

    Amazingly - because he could identify pictures of his grandchildren, his memory is fine. That is rubbish. He sees those pictures all the time and as he was rested - he was able to point out the people in the pictures.

    Making complex budgeting decisions is because he is not receiving significant input for memory problems... but they admit he was unable to calculate change in cognitive test... so how does that equate to - Can manage complex budgeting decisions unaided??

    So many issues in this report that words fail me.

  7. #7
    Further update - I now have a letter from my father's consultant Neurologist. He is rather scathing of the assessor to the extent he has even written:

    It is quite apparent that this patient's ongoing impairments, particularly his reduced insight and awareness, his inability to comprehend his needs and requirement for support, and his tendency to underestimate his own disabilities, have been ignored by the assessor, whom it would seem, also lacked insight into his needs.

    Definitely sending this letter in my Mandatory Reconsideration. I look forward to them saying they stand by their original award...

  8. #8
    Hope it goes well for you but dont be discouraged if there is no change invtheir decision thevtribunal WILL read everything. X

  9. #9
    Thank you Oimum. I know. I am quite relaxed about it - but it has impacted my mum who is extremely stressed while my dad doesn't understand the situation.

    I know that if we have to go to tribunal, then I have all the letters and proof that we need.

  10. #10
    Senior Member
    Join Date
    Apr 2014
    Location
    England
    Posts
    385
    Hello somenextperson

    I can't remember if you have contacted your dad's MP about what you are all having to go through. It may be an idea if not, at the very least it can them aware of what is going on and often helps to remind the DWP of all your evidence.
    Good luck.

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