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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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:
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.

RB68 · 10/04/2025 08:37

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

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

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.

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.

MissScarletInTheBallroom · 10/04/2025 09:22

That sounds so difficult. I would definitely appeal.

ByQuaintAzureWasp · 10/04/2025 09:27

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

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.

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

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

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.

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.

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

Kingsleadhat · 10/04/2025 11:09

Is there a charity in your area that helps with benefits claims? If not, try Citizens Advice. You need proper help with challenging this, it's a minefield.

Thelittleweasel · 10/04/2025 11:11

@toappealthisdecision @BananaSpanner

Please get this under way. I would certainly get your MP involved from the start.

If they are Labour you could instruct ["implore"] them to vote against the benefit cuts

Genevieva · 10/04/2025 11:13

PIP assessments seem to be subjective, so it is definitely worth a go. My understanding of recent announcements is that the downward pressure from government is to aim on the side of caution, not generosity, when assessing candidates. This is because of a funding crisis. Has she had any genetic testing? It would probably help enormously if they could identify a biological condition that demonstrates her disabilities are lifelong and non-curable, rather than mental health related.

DazzlingCuckoos · 10/04/2025 11:21

I never thought I'd ever say what I'm about to say.

I'm so pleased my sister is severely disabled!

She has the mental age of a toddler and cannot walk or talk, so the whole PIP assessment thing is so much easier as a result.

I'm sure you'll get a lot of advice here @toappealthisdecision but I just wanted to show solidarity. Your sister is in an awful middle ground position.

I agree though - appeal and get support in making your appeal. Would her key worker be able to provide advice? My sister is in a care home and the staff at the home are very good in advising on finances.

Genevieva · 10/04/2025 11:24

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!

I think you should also say in your appeal that her elderly parents are now unable to support her, so she will need more paid-for support, not less, to manage daily tasks like dressing, hygiene, preparing food, remembering to eat meals, coping with public transport… Cost it and show the shortfall.

I know a woman with a very similar profile who has one-to-one care support from when she gets up to when she goes to bed. She is very intelligent in some ways. An early reader with a small number of excellent GCSEs, but severe and complex congenital and psychiatric problems. She still gets lost in the small torn she has lived in all her life, if not accompanied. The state funded support she gets has been pared back, in the sense that she no longer gets fun days out with other local people (they used to go on a holiday camp once a year), but her day-to-day funding is sufficient. It sounds like that will not be the case for your sister without a successful appeal.

CosyLemur · 10/04/2025 11:27

Definitely appeal! I'm having to do this for my son. Apparently having to change from DLA to PIP has cured him of all his care needs and he can now live a normal life!
Even though at 16 he has the mental age of a 5 year old and can't even dress himself!

CalicoPusscat · 10/04/2025 11:38

I'm a bit shocked that they might even consider cutting funding for someone with your sister's needs @toappealthisdecision

Arthien · 10/04/2025 11:42

If she's in supported living, staff there should be able to work with you on this. Part of their job will be supporting with benefits applications and they'll be used to people having their money cut, and how to go through the appeal process with the right evidence

FootFlapperage · 10/04/2025 11:45

The first thing you need to do is get her GP to sign her off as unfit for work, the sick note can run for at least 6 months ..
Can you be with her when she has her appointment with the job centre. I found them to be very helpful. It won't take long after they meet her a few times that she's not capable of being employed. I wish you the best of luck.

Zilla1 · 10/04/2025 11:49

HNRTT but perhaps don't set too much store by the initial interview result. A majority of declunded claims that go to appeal succeed in a system that might appear designed to try to get claimants to give up. If you are a Band 5 then as well as local benefits advice and disability rights, perhaps see if any colleagues have similar experience and can help. The forms and appeal are a work and IME, HCPs with personal experience can be adept at successfully navigating the clais process.

Good luck.

TigerRag · 10/04/2025 11:50

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.

Don't pay for advice. There should be someone within her local supported living scheme who can advise on benefits. Either that or someone like CAB

LazyArsedMagician · 10/04/2025 11:52

I have no advice but I'm so angry on your behalf. Costs going up every year, but lets CUT what the severely disabled need. Disgusting behaviour.