Family member awarded enhanced pip - AIBU?

[Orangecrocs]

My family member has just been awarded enhanced pip in both living and mobility components.
Shes told me that she’s twisted the truth during the assessment and told the assessor that she has lots of pain and can’t really walk at all, but she walks all the time as I see her out and about - we live in a hilly area. I know people who are in a wheelchair and struggle to get enhanced rate - so I really don’t understand how she’s managed this.
I know people will say mind your own business but she’s told me she’s actually lied to them.

No. PIP is not means tested.

It’s absolute nonsense, as evidenced by the post from an actual assessor upthread. I was a disability benefits adviser/outreach worker for over 15 years and can attest to the fact that even those with severe and self evident disabilities had difficulty in securing the correct rate of benefit, and attended many appeal tribunals. It’s one of the hardest benefits to claim and has to be supported with robust medical evidence. DWP has actually been criticised, both for the dreadful quality of the award decision making, and the fact that they have forced clearly disabled claimants to expensive tribunal at the expense of the tax payer, despite it being clear that they were entitled to benefit. So I really don’t believe some of the stories posters have come up with to prove you can pull the wool over the assessors’ eyes. It’s actually quite insulting to the assessor. If you could just lie to the assessor and secure an award with no supporting evidence, then the tribunal service wouldn’t be necessary as everyone would be getting the benefit rate they’re entitled to. Which is not the case.

Lots of posters not understanding this, and also that it has nothing to do with being out of work. And we’re talking about a disability benefit here, which supports many with very severe conditions, many caused by birth defects. These people are among the long term unemployed/sick and some may never have worked due to disability. To talk about capital reserves in this context demonstrates a lack of understanding, not only of how disability benefits work, but, the circumstances of many who claim them.

It’s really not. I feel the same way having spent so long sorting people claims out. The hard reality is that when someone is reported for suspected benefit fraud it’s not just one benefit that’s stopped, it has a knock on effect on any other benefits they claim. And once benefit has been stopped it is not reinstated until the investigation is complete. Even then it takes time for benefit payments to restart. It causes real hardship and benefit advisers see this every day.

PIP assessors are healthcare professionals. They know how PIP rules should be interpreted and applied. And yet some posters here think (despite displaying breathtaking ignorance of what PIP is and what it’s for) they’re more qualified to decide. All this poster is saying is think before you report, because in most cases what you see, is most definitely not all there is.

I was awarded 0 points for mobility. Part of the argument was that I can use public transport. I've lost count of the amount of buses I've flagged down and the bus isn't in service. (I can see about 5-10 metres)

Got it looked at again and was awarded 12 points because I need help crossing roads. (I can't hear where sound comes from nor can I see that well) But apparently because I could flag down a bus meant I had no problems.

@GuPuddingRamekinHoarder PIP is a working age benefit and in most cases you can’t make a new claim for PIP after age 66. To still be claiming PiP after age 66, the most likely reason is your mum had an existing ongoing PIP claim at the time she reached that age, so it would continue for as long as she is eligible.

There are different rules around the PIP mobility component for those with an ongoing claim after age 66. If you weren’t in receipt of the mobility component before age 66 you can’t claim it after age 66. Similarly, if you were only entitled to the standard rate of mobility before age 66 then you can’t claim the enhanced rate after age 66 - even if your condition warrants it.

The PIP adviser you spoke to was correct. There is a disability benefit called attendance allowance which most people claim if they have a new disability after age 66. This benefit doesn’t include a mobility component because any new mobility issues after age 66 are considered age related, so not supported.

For general information. You can make a new claim for PIP after age 66 if your last PIP claim ended within the previous year, but you can only claim for a condition that formed part of your last PIP claim or if it’s related to that condition. For example, if your last claim was for diabetes and your diabetes has now made it harder for you to see, you can now claim PIP for your diabetes and your sight loss. And the same mobility rules would apply. You can’t make a new claim for any part of the mobility component unless you were claiming it as part of the previous claim.

But some people are awarded without providing evidence of the effect it's having on their day to day lives. A lot of the time evidence from GPs is just a list of diagnoses and PIP is about the diagnoses, you can have a diagnosis and not be effected severely enough to meet the descriptors for PIP. That may not be what happened here but it does happen.

PIP assessors are the lowest of the low.

She would be best applying for attendance allowance. This is the one for those over retirement age

Not if she already has a PIP award with a mobility award !

Sorry, I should have been a bit more specific. The physical ‘moving around’ descriptors for PIP don’t consider the ability to use public transport, or the provision of suitable local routes.

For a sensory disability you would have been assessed under the ‘planning and following’ a journey category. As far as I remember the only descriptor in which the ability to use public transport is considered is for 1D ‘cannot follow the route of an unfamiliar journey without another person, assistance dog or orientation aid’ would appear to be where you . Assessors are given clear guidance that to be considered able to satisfy this descriptor, the claimant must be able to use public transport - the assessment of which focuses on ability, not choice. This is because the ability to use public transport is, by nature, a requirement of the activity.

My DH has a power chair provided by the NHS through his OT. Is that not a possibility for you ? We are in Scotland, no idea how it works elsewhere. It makes no sense that you can’t get a car & a power chair with your PIP!

You're right, I didn't mean to quote this particular post, I was referring to the OPs original statement, but if the claimant has admitted to wilfully and knowingly lying in their application/assessment then their claim is false.

I've read through some of your other responses and I really respect your ethic and stance on this but not all assessors are made equal, they're not all good at their jobs, and fraudulent claims do exist.

Either way, my question really was what the OP was intending to do about it.

I find the anecdotes of people manipulating the system to claim disability benefits really difficult to believe, and very far from my own experience. We tried to claim PIP for my husband due to the impact of his mental illness. It was refused and we appealed up to and beyond tribunal. It was still refused.

A few months after the refusal, he was in hospital under section, and now he is in a care home.

My youngest son who is basically trapped in a routine of rituals and anxiety disorders also applied and was awarded two points. This was despite letters from his psychiatrist and notes from safeguarding meetings.

I know each case is decided according to its own context, but for every story of someone twisting the system, there must be hundreds of examples of people who are debilitated by their illnesses of impairments, but cannot access benefits that may support them.

No, she absolutely wouldn’t. If she is in receipt of the standard mobility component of PIP and has an ongoing award, she can’t claim the enhanced component because she is over the age of 66. But stopping the PIP claim and claiming AA instead would make her much worse off because she would lose the mobility component altogether - there is no mobility component to AA.

So many people seem ‘jealous’ of disabled people! We owned our small 2 bed house. 3 small kids & a DH with progressive MS which left him unable to work & really struggling with mobility. We were advised to apply for council housing & after a few years were allocated a 3 bed bungalow.
We pay full rent for this, no housing benefit. Our previous home was owned outright due to a critical illness policy paying off our small mortgage. But we were unable to get a mortgage for a suitable home, big enough for a growing family & suitable for a wheelchair user. So the proceeds from our house sale has been used to provide a better standard of living & security for our family. The resentment from others was quite an eye opener.
My DH was 29 on diagnosis, lost his career & independence & is now entirely reliant on others for everything! But I have had comments from people over the years that seem to think he has a great life , doesn’t have to work but isn’t living in dire poverty, has had holidays abroad etc ( not anymore he is barely able to leave the house & we haven’t been on holiday for 5 years). People just don’t seem to realise how hard some people have it & hate the idea they’re getting something they’re not!
DH gets enhanced PIP but nothing else as we have done savings (from house sale) & I have a decent salary from my pt job. My own sister made a comment years ago about him getting the equivalent of a pt wage while being able to be a SAHD. No concept of how much my DC had to do for themselves & how hard the school run etc was for DH!

I've been an advisor for a number of years and helped a lot of people to apply. I think there is a massive problem with people not being awarded what they should. I know I'll be shouted down but I also think there's a significant amount of people that are on higher awards than they should be and as others have highlighted I think it's often that they did qualify originally and have not reported changes when their conditions have improved. I think people just become completely reliant on the money and then it becomes hard to manage without it. If you've been on benefits for a while and then your condition improves, it must be scary to be worried about a sudden drop in income and it's not always easy to replace that income for example getting a job if you've not worked for some time. There needs to be more thorough assessments when a condition can improve, and no further assessments when a condition is chronic and unlikely to improve.

I agree that not all assessors are created equal, but good or bad, they all have basic rules to follow and ensuring that the claimants they are assessing have the most robust medical evidence to support it is one of them. Rather than fraudulently claiming it’s mostly been my experience that claimants have fallen foul of assessors who, for one reason or another haven’t properly referred to that medical evidence, or haven’t the skills to understand it and haven’t bothered to seek clarity. Consequently they’ve failed to appreciate the full extent of the effects of that claimants’ disability, which reflects in the level of award.

I’ve seen some really lazy assessment reports - full of contradictions and clearly failing to understand, and properly assess some of the functional ability. I’ve also had claimants showing me assessment reports in which things are documented that didn’t actually happen during the face to face interview. One claimant showed me an assessment report in which the assessor provided full documentation of the range of movement in limbs on examination, including estimated angles and expected functional ability. All without laying a finger on the claimant !! So I do tend to err on the side of the claimant, because by the nature of my work, the majority were those who had lost out through no fault of their own.

And regarding your question to the OP, I suspect they aren’t coming back. Hopefully some of the replies here have made them think before they report.

Totally agree with this! And I can empathise with people who are scared to lose that income. It can be difficult to get back to employment, more support is required. But it’s unfair that people are still claiming when they no longer qualify, while others have valid claims rejected. It’s a very difficult problem for the govt/DWP to ensure claimants are dealt with fairly & financial support awarded correctly to those in genuine need.

I agree with this 100%. I’ve seen it myself. The payments get absorbed into household budgets and claimants become reliant on them. So when their condition changes they are reluctant to report it in case the award is lowered or stopped. Even when completing review forms I’ve had real difficulty in making claimants understand that they are committing benefit fraud if they don’t report the change.

The DWP have introduced a system of ‘light touch’ reviews for those with open ended and ten year awards - these are the people with mainly permanent conditions which are unlikely to improve. I think that’s sensible, but at the same time I think some of the awards for low level disability should be reviewed far sooner than they are because, and I hate to say this, it was made clear to me on several occasions that some claimants’ conditions had improved or resolved long before they had received the official review. I’m not sure the obligation to report a change promptly, or the consequences of not doing so are made clear enough.

I had a client recently who applied for PIP a few weeks before turning state pension age and was awarded for a mainly arthiritic knee. She was awarded ten years which is completely crazy as she could be offered a knee replacement within a few years. Obviously you hope she would report the change but she talked about this award "setting her up for her retirement " as if it's just an extra boost to her pension. Like you I have to tell people over and over about the implications of not reporting changes. Not only did the PIP award give her an extra £100 a week but then an extra £81 of pension credit too, so £180 odd pound a week extra. First thing she did was book an extended trip to India with all the backpay after maintaining she could barely walk.

I agree but on the other hand my son has severe autism and learning disabilities, he's 14 ,non verbal, cognitively around 2 or 3 goes to a school for children with severe and profound learning disabilities, his circumstances are not going to significantly improve ,he currently gets HRC and HRM under SMI
I don't anticipate these rates changing when he moves to PIP ,but mu understanding is the longest he can be awarded for is 10 years .

Like I said in my last assessment I think for ongoing conditions that are not going to change, there should be no further assessments, i think they are looking into changing this, let's hope so.

I am autistic but “higher functioning” (whatever that means as I still have a lot of support needs) and my assessor gave me a short award of a lower rate because they think the help I am getting will enable me to be more independent one day which isn’t how it works lol

This too. I can quite see how a benefit like PIP can be absorbed into everyday costs and how claimants come to rely on it, but it was a definite problem trying to convince some claimants that they must report the change. I also saw a good many PIP claimants who were working when they first claimed PIP and by the time they had come to the PIP review they were unemployed/sick for various reasons, so money was far tighter and PIP was the difference between making ends meet or not.