Pip Appeal for fluctuating conditions

[FluctuatingMobility]

Evening all

I am after some advice if at all possible.

i originally scored minimal point for PIP. After a Mandatory Reconsideration I have enhanced daily living and lower level mobility - walking up to 50m.

I’ve had these issues for 15 years but every other time I attempted to apply I got zero points and didn’t pursue it as it was too stressful.

I have lots of physical health conditions however one of those is RA and it causes enormous pain and stiffness each morning. I have to take pain medications before getting out of bed despite biologicals, methotrexate & Duloxetene. I’ve exhausted pain management and already make use of various complimentary therapies inc hydro and physiotherapies. I’m out of options and been advised this is the best it’s going to get.

Case law suggests that if something affects me for part of the day then I should score the points. I physically cannot get out of bed on the majority of mornings till the meds have kicked in and then cannot walk even the 50m until the stiffness has subsided. Should this not qualify for higher rate mobility?

Added to that I have CPTSD and ongoing psychiatric support and heavy duty mood stabilisers for that and for anxiety and depression and literally rely on the car for mental health reasons but scored zero points for mental health on mobility.

i need to decide whether to appeal. I would really benefit from a car with some adaptations - I already have an auto but still struggle with various aspects of driving. I’m terrified of losing what they’ve awarded though. Has anyone been through similar with a successful outcome? Thank you all.

Hopeful bump!

Hi OP, I'm a disability benefits advisor and have represented many clients at tribunal. I'd be looking at whether you can come up with convincing medical evidence of the walking difficulty and whether you can argue successfully that you can't cover 20m safely/reliably/repeatedly. If you can do it a couple of times and then you're done for the day you shouldn't be assessed as being able to do it. Similarly if your knee gives way without warning (for example) you may not meet the 'safely' standard. Arguing that you can only do an activity at certain times of the day can be difficult - you really need to be able to show that the difficulty exists for the majority of each day.

Additionally, assuming you stated you had difficulty planning and following a journey on your PIP form, you may want to point out the restrictions on your driving, and mention if you find it difficult to cope with (for example) diversions to a familiar route or taking public transport. If you can get some points for this activity, it could be enough to demonstrate difficulty walking 50m, but the threshold for this activity is very high - you need to regularly suffer distress that leaves you completely incapacitated.

Deciding whether to appeal is a tough one, as you say there is a risk you would lose the award you do have. I'd be looking at the wording used on your decision letter (the original rather than the MR notice) - it will give you some clues as to why they decided on 50m. (I'm assuming you put 20m on your PIP form). It's usually worth requesting a copy of the health assessor report too if you haven't already done so. If the report has you stating in some form of words that you regularly walk 50m without difficulty it will be tough to turn around but if they have made assumptions based on answers you gave elsewhere there could be room for manoeuvre.

I've usually found appeals panels tough but fair. I have the feeling their default position is to side with the appellant, you just have to give them the justification to make the decision - written evidence is what comes down to in the end.

Wishing you all the best, whatever you choose to do.

Hi@DigitalGoat . I don’t think I will qualify for higher rate mobility after your explanation, I can’t get out of bed for up to an hour on waking and then shuffle about but after loosening up I can manage the 50m albeit with pain. I was confused and thought because I had the stiffness when waking every day it covered more than 50%of the week but it’s definitely not half of each day.

i genuinely struggle with diversions or when the sat nav plays up however mostly i do get on with it after pulling over up compose myself. Local familiar journeys are easier but it’s the constant worry of having a sudden flare up and getting stuck in random places that also causes stress driving. There’s no way I would manage using public transport - I also have incontinence which doesn’t help.

Sounds like I’m better to not appeal in case I lose it all. Appreciate your detailed response.