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AIBU?

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To appeal sister’s benefits?

113 replies

toappealthisdecision · 10/04/2025 07:22

Younger sister (in her 30s), I am her primary guardian as parents are incapacitated themselves unfortunately.

She has complex diagnoses - autism, ADHD, dyspraxia, dyscalcula, mild/borderline learning disability (IQ 70), a lot of mental health stuff (on 3 psychotropics including mood stabilisers) but no concrete diagnosis. She has epilepsy (generalised since childhood), asthma and IBS. She was queried for a genetic syndrome, they think possibly fragile X via my father - but not sure.

She has never worked or earned a wage. She lives in supported living scheme with 24/7 on site carers, although overnight they are not in her flat but are just down one flight of stairs on a sleeping shift - no waking staff overnight.

I can’t see her coping with a job. She does a voluntary thing 2 hours a day,, and she has a 2 or 3 basic qualifications (ie about the level you’d expect of a 11 year old) and can to an extent do kitchen portering and handle a till, again to a very limited extent. But she can’t do any of this to a level she would get paid for. No one would employ her. Reading age is about 9, writing is far lower.

She has zero idea of value of money or impulse control. Socially she is years and years behind and can be very disinhibited. She struggles to keep relationships and doesn’t know what is and isn’t appropriate. She really needs someone with her all the time who knows her and can help her - if she gets upset or overwhelmed she can go into sabotage mode and has been sectioned on 136 a few times because she’s a danger to herself and others. A lot of self harm and violence towards others. She’s also doubly incontinent for psychological reasons and struggles to keep herself clean.

She will never not need care. She doesn’t see it this way and believes she is going to find herself a neurotypical girlfriend and get married and have a lovely house with pets.

Her benefits have changed recently and she’s been told she’s losing £400 per month as she’s not allowed ESA anymore; so will lose severe disability payment - also has to change to UC. She will possibly have enough to live off but only just - ie she will struggle to pay for utility bills, will have a very, very basic standard of living.

I don’t know if that also affects council tax and housing benefit but suspect it will. she also has to pay a chunk towards her care that goes up every year.

Our local council have just made the step of closing down vast majority of learning disability and elderly care services - 70% of all council employees have been let go, most sheltered housing, care homes and similar are gone, no care at home workers, and there are now no day services either. Sister no longer has a social worker, he’s been made redundant as he only worked part time. I don’t know anyone is going to take over but I doubt it - because she is borderline IQ and has some family around she is not classed as highly in need.

I work full time but I only just earn enough for my own bills despite being band 5 NHS, I can’t afford to pay for her too much as I wish I could. One parent is in a care home and exists on £45 per week for personal spends, the other wouldn’t and couldn’t for various reasons.

She is however, only getting the lower rates of PIP, which makes me think we should appeal? Their argument is she can walk, eat and wash but she can only do these things with a trained adult or often 2 adults.

I’ve talked her through what I can and have explained I am prepared to try and appeal. Is it worth trying? I can’t believe her benefits can just drop by that amount so quickly.

There doesn’t seem to be any real support or advice out there for anyone in this boat, it’s not what I expected at 34 to be trying to sort out! I’ve got a couple of relatives who are my rock at the moment but just trying to find independent opinions on what to do

OP posts:
Mumble12 · 10/04/2025 11:09

Absolutely appeal, frustrating that you should have to. If she didn't have you, she would be in a terrible place by the sounds of it. What an awful system that could leave people in such dire straits! Best of luck x

Tangerinenets · 10/04/2025 11:01

toappealthisdecision · 10/04/2025 07:52

Yeah, she’s under an LD psychiatrist and has had SALT, OT, CPN, psychology involvement since about age 11 or so - will ask surgery if we can get copies of reports. My mum wasn’t great at keeping paperwork so I’ve got very limited access at the moment but her GP must have some documents!

Are you her Court of Protection appointed Deputy or do you have Power of Attorney? If not you may find it difficult to access any of her medical information or any private information really.

My son lacks capacity and I’m not currently his Deputy but I’m fortunate that I don’t have issues accessing his information but it just depends on the GP/social worker etc.

PivotPivotPIVOTT · 10/04/2025 10:58

There is a charity called Fightback for justice, who can definitely help her. I use their service every time me or a family member needs a form filling in, they’re amazing! They charge for filling in forms, but do waive the charge for some people if they cannot afford the fees. You can get it touch with them on Facebook. Also, as someone else has pointed out, if she’s receiving SDP with her ESA, and is being told she now has to migrate to UC, the SDP is protected by regulation 19, which means she won’t lose those payments. If she moves before the mandatory migration date, that’s when she’d lose it.

Branwells77 · 10/04/2025 10:41

Contact your local citizens advice or welfare rights if she is being moved from ESA she should get transitional protection so she doesn’t lose any money changing to UC she should also be entitled to the LCWRA element of UC (disability) you can put in for a change of circumstances with PIP however they will look at the whole claim again so ensure you have recent medical evidence to send with the COC. You absolutely need to seek help from CAB or WR with this.
Good luck hope you get your sister sorted

BoldAmberDuck · 10/04/2025 10:40

toappealthisdecision · 10/04/2025 07:52

Yeah, she’s under an LD psychiatrist and has had SALT, OT, CPN, psychology involvement since about age 11 or so - will ask surgery if we can get copies of reports. My mum wasn’t great at keeping paperwork so I’ve got very limited access at the moment but her GP must have some documents!

If you get get registered on the NHS app you should be able to look at everything

LoveSandbanks · 10/04/2025 09:44

Definitely appeal, I have two young adult sons with asd and adhd but no learning difficulties, both get high rate care and mobility. They also both get the disability element of UC and are in the lcwra group.

ByQuaintAzureWasp · 10/04/2025 09:27

You've nothing to lose. Appeal. Good luck!

MissScarletInTheBallroom · 10/04/2025 09:22

That sounds so difficult. I would definitely appeal.

Tortielady · 10/04/2025 09:19

Most claimants for PIP (and other benefits) do better at appeal if they have representation. Those with very complex needs like your sister really need the extra help and advocacy a good advice worker can offer. Contact your local CAB as soon as you can and show them what you've told us here as it's a very sound summation of the problems your sister has and her need for continual supervision and support. She's lucky in at least one way - she's got you in her corner. Wishing you and her all the best.

ohdearagain2 · 10/04/2025 09:12

Op I don't know but I just wanted to give you my support. Its people like you and your sister who I think we should as tax payers be giving the chance to not only just exist but achieve a decent quality of life. To me that's a measure of a decent society and its a tragedy if that has been taken away. I hope you are able to get things sorted.

Snapncrackle · 10/04/2025 08:43

Locutus2000 · 10/04/2025 08:32

it sounds like it was ESA with the Severe Disability payment
this is nothing to do with PIP which is a separate benefit

Severe Disability Payment is everything to do with PIP/DLA as you only get it if claiming ESA and PIP/DLA.

Apologies your correct
I read the op post wrong

RB68 · 10/04/2025 08:37

If GP doesn't play ball look at doing a Freedom of Information request on the records

TiredArse · 10/04/2025 08:35

Are you her appointee for benefits? If not you could apply to do this so you can speak for her at the assessment and provide accurate info.

Locutus2000 · 10/04/2025 08:34

newtb · 10/04/2025 08:26

There's also the site benefits and work that I found very helpful. They even had the scores used in assessment.

Benefits and Work is a dodgy operation charging real money for what you can find with a Google and helping fuel the conspiracy theories.

RB68 · 10/04/2025 08:34

I would definitely appeal and also get a professional to help you out with this one - they are being devious saying she can do those things when she can't on her own. Further I would get in touch with social services re adult care and see if she is entitled to other bits and bobs which can make all the difference with regard to pence in her pocket. for e.g. incontinence pads if needed, some help with cleaning, UC should still have rent and council tax elements. You may find as she is in this sort of care she has other entitlements as well. I would also talk to her utilities and make sure she is on the cheapest rates and see if there is anything they offer to help out as well.

If she ends up not getting extra, try contacting foodbanks as well, they do hygiene ones as well as food and when you are on a budget knife edge like this every single thing helps.

Also are there more relatives? Whilst you all cannot afford to help her out hugely maybe a little from everyone would make the difference e.g. £10 each from 5 is £50 and that is her food covered for a good period or one of her bills

I often think people who struggle to advocate for themselves loose out in these situations and yet they are the people most in need of the benefits and who they are meant to support

Locutus2000 · 10/04/2025 08:32

Snapncrackle · 10/04/2025 08:18

before you appeal you need to know exactly shag she was getting and what she has lost

Was it a ESA assement or PIP

it sounds like it was ESA with the Severe Disability payment

this is nothing to do with PIP which is a separate benefit

if she is being moved over to UC her money shouldn’t change if she was on the old style legacy benefit with SDP

it sounds like it was ESA with the Severe Disability payment
this is nothing to do with PIP which is a separate benefit

Severe Disability Payment is everything to do with PIP/DLA as you only get it if claiming ESA and PIP/DLA.

Snapncrackle · 10/04/2025 08:31

It sounds like she was in the support group of ESA on the old benefit system and has had a in face assessment of her ESA award
it has to be ESA as that’s the only award with Severe disability payment

if she is now in the work and support group this means she will lose the SDP and the money for being in the support group and will be required to apply for UC

so she would only be getting around 100 a week if she is either a job seeker or looking for work with support group

to stay on the same amount with UC you need to supply a fit note when you apply and then she will get assessed again at some point

she should still get her rent / ct paid under universal credit but she will be expected to look for work under UC rules

KitsyWitsy · 10/04/2025 08:30

Surely she is just changing over to UC asESA is an old benefit? It doesn’t sound like she will have any issue getting the full rate of UC with the limited capability of work. No point whatsoever appealing as her benefits haven’t been reduced, they are just changing to the new system

SkaneTos · 10/04/2025 08:30

BananaSpanner · 10/04/2025 07:29

I think I just voted yabu by accident so apologies for that. Yes, appeal. She sounds like someone benefits were invented to support and I’m very sorry for you they’ve been reduced. I don’t know how successful appeals are. Would your local MP get involved?

You can change your vote by clicking on the other option. I learned this from another poster a few months ago.

Zapx · 10/04/2025 08:26

Definitely appeal. Someone in my family is very similar, no idea with money, IQ about 70, epilepsy, needs help and pretty much constant supervision etc and has recently been awarded highest rate Pip for 10 years.

newtb · 10/04/2025 08:26

There's also the site benefits and work that I found very helpful. They even had the scores used in assessment.

Snapncrackle · 10/04/2025 08:18

before you appeal you need to know exactly shag she was getting and what she has lost

Was it a ESA assement or PIP

it sounds like it was ESA with the Severe Disability payment

this is nothing to do with PIP which is a separate benefit

if she is being moved over to UC her money shouldn’t change if she was on the old style legacy benefit with SDP

shellyleppard · 10/04/2025 08:05

I would definitely appeal. Citizens advice are excellent for this, they can do meetings in a convenient location (doctor surgery).: good luck x

Nonametonight · 10/04/2025 08:01

I think you need to get some benefits advice really - if she's being migrated over to universal credit then her ADP entitlement should be protected through a transitional element. Whether she's entitled to the higher rate of pip or not will depend on exactly how her needs match up against the pip descriptors, and it's best to go through that with someone who knows what they're doing

Octavia64 · 10/04/2025 08:00

A lot of pip is about paperwork.

speak to the gps and ask for a summary printout of her medical record. That will have dates and diagnoses on.

you may also be able to persuade them to include access to some letters - if she has been sectioned this is also evidence.

if she is living in supported accommodation they will also have documentation- speak to them and ask to see her care plan or equivalent.

yes, appeal.