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.

PIP is an odd thing. Some people really struggled to get it. Others sail through. You don't need a diagnosis, just needs that match the criteria & will last over six months.

I've had PIP more of my life than not, from my early teens. I know that peoples conditions vary & mental health can also qualify but I do not believe the large increase in numbers claiming.

I've not had to provide evidence for 15 years now, I offer in but it's never been requested. I check.
I know others have had the same treatment, yet some who fail & have to appeal.

People who cheat, lie, exaggerate needs for PIP or carers allowance should be ashamed. I & others don't have the luxury of switching our issues on & off. There are real everyday costs to disability & the money provided doesn't go far enough when you look at care fee's & equipment.

Those with the highest costs should receive the most money. I also think people need to remember there has to be a cut off somewhere & not getting PIP doesn't mean a person isnt disabled, just not enough for/failed by the system.

It's crazy someone deaf, blind, suffering paralysis, unable to move muscle, feeding tube, catheter, hoisted, no capacity, the works, get the same as someone who can walk & needs help having a washing.

I know I'm not giving the best example but disability varys so much more than three payment levels, disabled but no PIP, standard PIP, or enhanced PIP.

I'd have no issue reporting suspected cheats, but my threshold would be quite high, eg someone admitted it as you rarely know another's life.

🤣🤣🤣🤣🤣

This is not meant as criticism at all, just clarification. You can’t have been claiming PIP for fifteen years because it was only rolled out to replace DLA in 2013 - 11 years ago.

I suspect that before that you were claiming DLA or child DLA, depending on your age. So at some point you would have had to fill in a PIP application form at the point of migration from one benefit to the other. The eligibility for PlP is completely different from DLA but if you were in receipt of long term DLA it’s possible that there was enough existing medical evidence to support your PIP claim - especially if you have a permanent condition which is unlikely to change. But l think it’s important to point out that that would not be most people’s experience, as at the time PIP was rolled out 90% of claimants underwent a face to face assessment - the only way to avoid that at the time, was to present robust supporting evidence with the claim.

And with respect, even with a long term or open ended award for the more severe/stable conditions, DWP do make periodic checks to ensure nothing has changed. You likely wouldn’t know they had happened if they are ‘light touch’ reviews - they may write to or phone your nominated healthcare providers or there could just be a paper review by a DWP assessor. They wouldn’t necessarily contact you directly unless they needed more information.

And l take issue a bit with this statement ”It's crazy someone deaf, blind, suffering paralysis, unable to move muscle, feeding tube, catheter, hoisted, no capacity, the works, get the same as someone who can walk & needs help having a washing”. PiP is based on the cost of living with a disability and different disabilities affect people in different ways. It’s unfair to compare the effects of different conditions in this way, because each person will have different needs and that will affect their individual costs. As has been said often here, what you see on the surface is very rarely all there is. Disabled people face enough judgement as the result of ignorance from those who don’t have a disability, without having to face the similar attitudes from those who do.

Apologies . I'd missed that she is already on pip

It’s not easy to claim. As someone who submitted a claim for someone with a terminal diagnosis (which is supposed to fast track the claim), they still had to run a lot of checks with the GP/other professionals and the first and only payment wasn’t made until after they passed away.

I’m sorry this happened

I get adult disability payment and I can hardly function most of the time. I suffer from dizziness, migraines, insomnia, chronic pain etc. It is hard for me to concentrate for long. I push myself until I can’t function anymore, i am prone to burn out. I see 2 mental health workers each week if I’m well enough or it’s a phone call. I can’t go out anywhere and I don’t have friends but I spend the money on books when I can concentrate on them, plants, and craft hobbies for my mental health. I also see a tutor about once every 2 weeks as I didn’t get qualifications from being home schooled and I will eventually be working from home. If I spent money on help around the house, I would have nothing left and I would just exist and lose my will to live.

And this is the crux of it.

In all my professional experience of PIP, many people who should be in receipt of it had a battle to get it and others didn't.

And PIP claims are now out of control and it needs review.

But I don't know how to weed out the people who need it from the ones who don't so inevitably, some genuine claimants will suffer from reform which is very much needed.

This

This is the problem. In every round of welfare reform it’s always the genuine claimants who come off worst from tightening of eligibility and assessment criteria - especially the most severely disabled because they are the ones who cost the most and are the most visible as such. In recent years there has been a disconnect with these conditions and some disabled people are given the runaround in the hope that they will give up and not reapply or go as far as tribunal. It’s benefit savings by the back door.

I think it’s time for a full scale review of what does and doesn’t qualify as a ‘disability’. Low level and temporary conditions never used to qualify for DLA. I think with the introduction of PIP it was high time that mental health, sensory and cognitive conditions were included, as they were mostly ruled out for adult DLA, but there needs to be a wide ranging rethink because in supporting a myriad of lower level needs, we’re in danger of not being able to properly support those people with life affecting/changing levels of disability.

This is absolutely not usual though. With a special rules claim as long as an SR1 form is submitted ( formerly known as a Ds1500 ) then the claim is processed and paid within 2-3 weeks. I have applied for PIP for hundreds of people under special rules and only in a very small handful of cases have I known the SR1 form be queried by DWP, usually where it was a Gp who had issued it and perhaps didn't have full understanding of the criteria. I'm sorry it happened in your case but just don't want people to think this happens a lot. With the correct form it's usually very straightforward. They often pay enhanced rate mobility too with little to no checks, just on the basis of the form and applicant answering a few questions.

Hi, I had submitted everything correctly and in a timely manner. Chased for updates constantly. They had no explanation for why it took so long and issued an apology.

So the government are saying they want to claw back another 1.5 billion by cracking down on benefit fraud. Apparently the PM addressing this in his speech today. If it's not disability benefits that are being fraudulently claimed, it will be interesting to see what they will target. Do we think it's all UC/ Hb fraud?

You just need to read the descriptors. They are very clear. DC gets high rate mobility because of severe LDs. They cannot leave the house alone at all and travel to place independently (not even a walk to the corner shop). Makes perfect sense to award high rate mobility if you completely depend on another human to set a foot in front of the house!

I think first you have to consider that your experience isn't everyone's. So while your standard mobility award is relevant to your situation with mental health, it isn't reflective of everyone who has mental health difficulties- these vary widely.

I have a DC who will be moving from child to adult disability (Scotland) very soon and fully expect them to be awarded the enhanced rate based on descriptor E: cannot follow the route of a familiar journey without another person, an assistance dog or an orientation aid

That is descriptor F, not E.

Descriptor E is 10 points so only standard rate mobility and is for being unable to undertake any journey because it would cause overwhelming psychological distress.

So child DLA at the moment. At some point after he turns 16 he will be migrated to PIP, and the eligibility conditions are very different from DLA, but when you receive the application form for PIP, you can ask DWP for any medical or other evidence already supplied for the DLA claim to be considered for PIP if it’s still relevant.

For conditions which are severe and not likely to improve in the long term, a claimant can receive an ‘open ended’ award. In practice this means around ten years, and these kinds of awards usually have ‘light touch’ reviews. This means that an assessor looks again at the claim and decides whether to contact healthcare providers or the claimant themselves. I’ve known claimants to not even be aware that a review has been carried out as there has been no need for them to be contacted, and the award has been renewed.

Yep. It’s the same for PIP. I think people get confused with descriptor E because it’s the only way to qualify automatically for a blue badge if you are applying solely on the grounds of mental health or cognitive/sensory disability. It will qualify you for a blue badge without further assessment from the local authority, but only awards ten points for the mobility component and would not, on its’ own, qualify a claimant for the enhanced rate.

Descriptor E won’t qualify him the enhanced rate, as it only awards ten points and you need twelve for the enhanced rate. Descriptor E is the only descriptor which will automatically. qualify a claimant for a blue badge solely on the grounds of mental health/cognitive/sensory disabilities. Even if you qualifed with descriptor F for the full twelve points you would still have to undergo the local authority assessment for a blue badge.

The rules for a blue badge are different in Scotland. In Scotland, 10 points on the planning and following a journey activity is not one of the automatic qualifiers for a blue badge. 12 points is.

In my experience PIP was far easier to achieve than a blue badge though we very very obviously qualify for both.

@Rosscameasdoody

Sorry I mistyped its descriptor F

I did copy the correct text, just wrote the wrong letter

also, it is F for a BB entitlement in Scotland.

Wow, thanks for that info. I’ve not actually dealt with ADP, as I’m in England. On bringing up the descriptors for both ADP and PIP they’re very similar, but I was really surprised to find you need the full twelve points to be entitled to a blue badge on MH grounds alone, with no further local authority assessment - so basically only the advanced rate counts for that, and yet the standard rate from eight points in the moving around descriptor is an automatic qualification. So they’re holding mental health/sensory and cogntive disability to a much higher standard.

It's the same in Wales - you need 12 points on planning and following a journey for an automatic blue badge

Will be interesting to see what he has to say. One of the things they’re staying very tight lipped on is whether they will take forward the Tories’ plans to monitor the bank accounts of benefit claimants. This was supposed to be fully operational from 2025 with the relevant AI systems installed and with the appropriate legislation in place . It will compel the banks to monitor and report unusual activity on the accounts of benefit recipients to DWP. Labour were squealing ‘big brother’ when they were in opposition. Now they’ve seen the scale of the financial mess we’re in, I wonder if it will be quietly slipped in under the radar.