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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:
Locutus2000 · 10/04/2025 07:58

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

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.

Anyone on PIP being forced onto UC/New Style ESA is entitled to transitional protection against losing their SDP so I can't see how she will lose £400pcm - is someone getting mixed up with the Green Paper proposals?

It can affect council tax as some councils have used the UC switch to reduce the subsidy but it will still be at least 75% reduction.

People on 'low rate' PIP are generally not advised to appeal for more due to the risk of losing the lot, especially if SDP is involved.

toappealthisdecision · 10/04/2025 07:52

FelloffaCliffedge · 10/04/2025 07:42

Definitely appeal but get supporting evidence from professionals who know her. Medical diagnosis is not as important as having robust evidence about how her disability affects her. If she’s that impaired she must have had plenty of people involved with her care over the years.
If she’s in supported accommodation she must have been assessed as needing that by someone? Get a hold of those reports and submit them as the basis of an appeal

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!

OP posts:
WonderingWanda · 10/04/2025 07:45

Yes absolutely appeal. Insist on a new social worker before hand and ask for them to be present and have met your sister and you first so they can also fully understand her difficulties.

FelloffaCliffedge · 10/04/2025 07:42

Definitely appeal but get supporting evidence from professionals who know her. Medical diagnosis is not as important as having robust evidence about how her disability affects her. If she’s that impaired she must have had plenty of people involved with her care over the years.
If she’s in supported accommodation she must have been assessed as needing that by someone? Get a hold of those reports and submit them as the basis of an appeal

JohnofWessex · 10/04/2025 07:40

Useful tips.......

Always ask for a PIP assessment to be recorded and if it goes to appeal ask the DWP to provide a transcript of the assessment.

Ask for a hearing and go, and

Bring a third party with you, not Rumpole of the Bailey but someone who knows you or the claimant whoi can hold your hand and add their comments to the questions.

Something like 9i0% of PIP appeals are upheld withiout additional evidence

MaMaMaMaBaker · 10/04/2025 07:40

CAB sounds like a good shout out to me too.

Tangerinenets · 10/04/2025 07:37

Yes definitely appeal.

toappealthisdecision · 10/04/2025 07:34

The thing is she had a face to face assessment when the decision was made, she sat silently and glared at the floor the entire time but someone still pronounced her as being not that challenged and therefore able to work. I think because from the outside she just looks socially awkward and like any number of people you might see only a daily basis - she can type, pick up a coin, lift a pint of milk etc - it’s only once you are with her 24/7 that you realise actually, she’s not coping all that well at all and really does need someone with her all the time. Little things like if her bus was cancelled she would not know what to do at all and would be liable to scream and shout and swear at the bus office staff.

I’m not sure re MP, there’s been a big enough argument that the MP has done sod all about the en masse closures so I’m not sure - worth a try though. I’m going to take a few days in my AL to sit with her and go through everything that I can and try and get it all sorted.

Citizens advice is worth trying yes, I’ll see if they still have a local office!

OP posts:
Theunamedcat · 10/04/2025 07:34

Appeal but reach out to people who can help you appeal there is free help available font pay for it! Often it's the wording that trips you up in these forms you MUST STRESS the help and support they are getting to do these things it's the difference between "can get dressed under supervision" and needs clothing set out and repeated prompting to dress themselves needs support on deciding appropriate clothing for the weather, see the difference?

IHeartHalloumi · 10/04/2025 07:33

Definitely appeal. Have you spoken to citizens advice?

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?

MaMaMaMaBaker · 10/04/2025 07:26

You know her better than the DWP. The benefits system is unfairly scored anyway and they're very well known for making mistakes whilst they're about it.

I wish I could reassure you that it will be productive, but I do think it's worth a try.